An Unusual Cause of Acute Pancreatitis: Annular Pancreas and Papillary Opening of the Cystic Duct

Annular pancreas is a rare congenital anomaly in which the pancreatic tissue forms a complete or partial ring around the descending duodenum. Findings in an autopsy series indicated a prevalence of 5 to 15 cases per 100,000 adults. There are two peaks of presentation, first in infancy (52%) and second in the fourth decade of life (48%).1,2 Opening of the cystic duct to the papilla without combinig with common biliary duct is also extremely rare. We report the case of a patient with annular pancreas associated with an unusual biliary anomaly which complicated by pancreatitis. A 45-year-old woman was admitted to the gastroenterology department with acute epigastric pain radiating to her back. Her past medical history was unremarkable. She abstained from al