CureusJul 29, 2026

Blocked Stomach Outlet in an Adult with Ring-Shaped Pancreas After Starting Semaglutide

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Aug 3, 2026

Abstract

A 55-year-old male with type 2 diabetes experienced progressive postprandial vomiting and a nine-kg weight loss following the initiation of semaglutide.

Annular pancreas is a rare congenital condition that can remain asymptomatic until adulthood.
In this case, imaging revealed a partial annular pancreas causing second-part duodenal narrowing.
Symptoms persisted even after discontinuation of semaglutide, indicating a fixed mechanical obstruction.
The patient underwent successful Roux-en-Y gastrojejunostomy and cholecystectomy, with benign fibrotic tissue confirmed on histopathology.
After treatment, the patient reported being symptom-free and achieved nutritional recovery.

Simplified

Annular pancreas is a rare congenital anomaly that may remain clinically silent until adulthood. Its symptoms can be masked or exacerbated by glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which delay gastric emptying. We report a 55-year-old male with type 2 diabetes who developed progressive postprandial vomiting and nine-kg weight loss following semaglutide initiation. Imaging revealed a partial annular pancreas causing second-part duodenal stenosis without malignancy. Symptoms persisted despite semaglutide discontinuation, supporting a fixed mechanical obstruction as the primary aetiology. The patient underwent successful Roux-en-Y gastrojejunostomy and cholecystectomy; histopathology confirmed benign fibrotic pancreatic tissue. At follow-up, the patient was symptom-free with nutritional recovery. This case emphasises that severe gastrointestinal symptoms in patients on GLP-1 RAs should prompt evaluation for structural pathology rather than being attributed solely to medication side effects, ensuring timely surgical intervention.

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Competing interests

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

PubMed

Blocked Stomach Outlet in an Adult with Ring-Shaped Pancreas After Starting Semaglutide

Abstract

Full Text

Funding

Competing interests

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