COMPLEX RECURRENT PANCREATITIS IN AN ATHLETE WITH ANNULAR PANCREAS AND SECONDARY AMPULLARY TUMORS: A DETAILED CASE ANALYSIS

Abstract

Annular pancreas is a rare congenital condition characterized by a ring of pancreatic tissue encircling the duodenum, which can lead to a variety of clinical manifestations. While many adults with this condition remain asymptomatic, it can occasionally cause severe gastrointestinal symptoms and complications, including recurrent pancreatitis. This case report focuses on a 71-year-old female athlete who presented with recurrent episodes of pancreatitis, initially undiagnosed due to the non-specific nature of her symptoms and the rarity of the condition. Further investigations revealed an annular pancreas, complicating her clinical picture with gastric outlet obstruction symptoms such as abdominal pain, vomiting, and bloating after meals. Additionally, she developed secondary ampullary tumors, a serious complication that exacerbated her condition by obstructing bile and pancreatic ducts, thereby precipitating recurrent pancreatitis. The diagnosis of annular pancreas in this elderly athlete posed significant challenges due to the overlapping symptoms with more common gastrointestinal issues and the patient's advanced age, which could obscure typical presentations. Her management required a multidisciplinary approach, involving gastroenterologists, oncologists, and sports health specialists, tailored to address both the immediate complications and her long-term health and athletic activities. This case underscores the need for high suspicion of rare anatomical anomalies in patients with unexplained recurrent pancreatitis and highlights the complexities of managing such conditions in older athletes, balancing the need for aggressive treatment with the preservation of function and quality of life.