Embryology: annular pancreas: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Anatomy · Embryology: annular pancreas

Sample item

A newborn with Down syndrome has bilious vomiting and a double bubble sign. At surgery, pancreatic tissue encircles the second part of the duodenum. What is the embryological explanation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Abnormal migration of the ventral pancreatic bud around the duodenum

In annular pancreas, the ventral bud, or part of it, migrates abnormally around the duodenum so that a ring of pancreatic tissue encircles the second part and may cause obstruction. It is associated with Down syndrome and presents with a double bubble sign; treatment is duodenoduodenostomy, not resection of the ring. Pancreas divisum is a different anomaly.

Option by option

  • A. Failure of recanalisation of the duodenal lumen

    Failure of recanalisation produces duodenal atresia or stenosis, with no encircling pancreatic tissue.

  • B. Abnormal migration of the ventral pancreatic bud around the duodenum (correct)

    Correct. The misplaced ventral bud forms a ring around the duodenum.

  • C. Failure of fusion of the dorsal and ventral pancreatic buds

    Failure of fusion of the buds produces pancreas divisum, with no ring around the duodenum.

  • D. Failure of rotation of the midgut loop around the SMA

    Malrotation produces volvulus and Ladd bands, not a ring of pancreas.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anatomy questions

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is B, Abnormal migration of the ventral pancreatic bud around the duodenum. In annular pancreas, the ventral bud, or part of it, migrates abnormally around the duodenum so that a ring of pancreatic tissue encircles the second part and may cause obstruction.

Why is "Failure of recanalisation of the duodenal lumen" not the answer?

Failure of recanalisation produces duodenal atresia or stenosis, with no encircling pancreatic tissue.

Why is "Failure of fusion of the dorsal and ventral pancreatic buds" not the answer?

Failure of fusion of the buds produces pancreas divisum, with no ring around the duodenum.

Why is "Failure of rotation of the midgut loop around the SMA" not the answer?

Malrotation produces volvulus and Ladd bands, not a ring of pancreas.

What concept does this question test?

It tests Embryology: annular pancreas in Anatomy. It is associated with Down syndrome and presents with a double bubble sign; treatment is duodenoduodenostomy, not resection of the ring. Pancreas divisum is a different anomaly.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Embryology: annular pancreas?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.