Annular Pancreas and Superior Mesenteric Artery Syndrome: Rare Etiologies and an Exceptional Association – A Case Report

Annular pancreas and superior mesenteric artery syndrome are rare anatomical abnormalities, even more unusual when they coexist. This case report presents a 21-year-old patient suffering from recurrent acute pancreatitis and postprandial vomiting. Imaging revealed an annular pancreas encircling the duodenum, causing partial stenosis, and duodenal compression by the superior mesenteric artery (with an aorto-mesenteric angle reduced to 18°), characteristic of superior mesenteric artery syndrome [1, 2]. This association created a vicious cycle: duodenal obstruction and stasis promoted pancreatitis, while weight loss exacerbated mesenteric compression [3]. Initial treatment was medical (rehydration and parenteral nutrition), with surgical intervention (duodenojejunostomy) undertaken after failure of conservative measures. This case underscores the importance of a multidisciplinary approach to diagnose and manage these complex anomalies [4].