Duodenal and Bile Duct Narrowing Due to Partial Annular Pancreas: A Rare Association

Annular pancreas consists of a ring of pancreatic tissue partially or completely encircling the descending duodenum. It is an unusual congenital anomaly rarely detected in adult life. Gastric outlet obstruction is most common presentation mainly in 2nd or 3rd decades of life. We are reporting an unusual association of partial annular pancreas - a dilated biliary system due to distal common bile duct (CBD) stricture without features of pancreatitis or underlying malignancy which is rare and not reported previously .Our patient also had gastric outflow obstruction. This may be explained by the pancreatic tissue encircling the duodenum at the level where CBD joins the papilla causing dilated CBD and duodenal stenosis.