Figures at a glance

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

FIGURE 1

Figure 1: Endoscopic retrograde cholangioscopy
In the distal hepatocholedochal duct there seems to be a contrast media sparing concrement or adenoma (red arrow).

FIGURE 2

Figure 2: CT-Scan of the duodenal region

The red arrow points to a suspicious tissue surrounding and pressing in the pars decendens duodeni ("crocodile jaw"). The previously implantet stent (green arrow) enters duodenum aboral to the ring-like tissue.

FIGURE 3

Figure 3: Intraoperative Picture of annular pancreas The descendent part of duodenum is totally encircled with pancreatic tissue (green arrow). Ampulla of vater has not been detectable.

FIGURE 4

Figure 4: Photography of the ampulla of vater
In the center of the duodenotomy the ampulla has been exposed (green arrow). The adenoma is not shown.

FIGURE 5

Figure 5: Treatment scheme for annular pancreas patients