Annular pancreas with duodenal enteroliths of biliary type: fifty years' survival following gastroenterostomy (original) (raw)
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Journal of LIberia Medical and Dental Association, 2017
Background: Annular pancreas is one of the rarest causes of acute duodenal obstruction in neonates. The exact prevalence of annular pancreas is unclear as many individuals with annular pancreas are asymptomatic. We present a 7-day old male neonate who presented with non-bilious effortless coffee-ground vomitus from birth. He passed meconium with no subsequent motion of stool for 6days. Her radiograph showed a double bubble sign. He was diagnosed with a neonatal duodenal obstruction. Objective: To highlight the challenges in the diagnosis of neonatal duodenal obstruction. Materials and methods: The study is a case report of Annular Pancreas causing duodenal obstruction. The chart was retrieved and reviewed for the patient’s age, sex, clinical presentation, diagnosis and treatment. A search was conducted on the MEDLINE database for all applicable research; clinical reviews, retrospective studies and case reports. Results: The patient underwent duodeno-duodenostomy for an annular pancreas and the postoperative course was uneventful. Conclusion: Annular Pancreas is a rare disease in neonates causing duodenal obstruction. Imaging is supportive, but the diagnosis is confirmed by laparotomy. Duodeno-duodenostomy remains a viable operative option in neonates, Recommendation: A high index of suspicion is required by clinicians for diagnosis to avoid complications of delayed surgery.
Annular pancreas producing duodenal obstruction: A case report
Open Journal of Gastroenterology, 2013
Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue surrounding the duodenum. This malformation is usually asymptomatic in adults, but can manifests as pancreatitis, duodenal stenosis, or duodenal or gastric ulceration. We report the case of a young patient of 18 years old hospitalized for epigastric pain and vomiting, in whom radiological investigations showed an annular pancreas. At operation, a complete obstruction of the duodenum between its first and second parts was found, caused by an annular pancreas. No other congenital anomaly of the intra abdominal organs was noted. A gastroenterostomy was performed. Both the rarity of this congenital abnormality and its successful correction by surgical means have prompted us to make the following presentation.
Annular pancreas in children: A recent decade’s experience
Journal of Pediatric Surgery, 2004
Purpose: Annular pancreas is a recognized cause of duodenal obstruction in children. The authors sought to characterize the clinical, radiologic, and prognostic findings in this disorder through a 10-year review of all patients with annular pancreas.
Annular Pancreas Producing Duodenal Obstruction* Report of a Successfully Treated Case
Annals of Surgery, 1944
THERE has recently come under our care a newly born infant with evidence of duodenal obstruction, which was proved to be due to an annular pancreas. Operation on the third day of life has brought about complete relief of the baby's symptoms. Both the rarity of this congenital abnormality and its successful correction by surgical means have prompted us to make the following presentation: Case Report.-S. M., a three-day-old female infant, was referred to the Children's Hospital by Dr. Dorothea Moore on September i6, I942, because of persistent vomiting of two days' duration. During the mother's pregnancy there had been a moderate hydramnios. The infant was delivered at full term after a short, uncomplicated labor. The birth weight was 5 lbs. I2 Oz. Four hours after birth the baby passed a normal-appearing meconium stool. Shortly after this she vomited. During the remainider of the first 24-hour period there was vomiting on four occasions. At no time was the vomitus bile-stained. On the second day the baby was put to the breast, and suckled well, but there was projectile vomiting of curdled milk after each nursing. Again, there was no bile staining. Two meconium stools were passed. On the third day of life, the course was essentially the same, and was characterized by repeated vomiting and by the passage of only a small amount of meconium by rectum. Physical examination on entry showed a small but normally developed infant, as far as external appearances were concerned. Temperature I00.40 F. Pulse I40. Respirations *
Annular Pancreas with Duodenal Stenosis and Intestinal
2013
Objective – To describe a rare case of a combination of annular pan-creas with malrotation in early childhood. Case report – The patient is 2 year old aged girl with persistent non-bilious vomiting. She was vomiting several times a week, and over the ten days prior to presen-tation as many as several times a day. Upon presentation, the patient had an unremarkable abdominal exam with no abdominal pain. An upper gastrointestinal study showed extreme dilatation of the stom-ach and the duodenal bulb, and an abdominal computer tomography scan revealed an annular pancreas. Intra-operatively we find an an-nular pancreas and treated it by duodeno-duodenostomy, while the intestinal malrotation was treated by Ladd’s procedure. Conclusion – Annular pancreas is a rare congenital anomaly which in childhood is related to duodenal atresia or stenosis and often affiliated with in-testinal malrotation. Key words: Annular pancreas ■ Malrotation.
Annular Pancreas in Neonates; Case Series and Review of Literatures
Background: The annular pancreas is a rare congenital disorder of the pancreas first recognized in 1818. It is believed to result from faulty rotation of the ventral pancreatic bud in its course around the posterior aspect of the duodenal anlage. The duodenum is encircled and might be obstructed by normal pancreatic tissue. The management of the annular pancreas is still developing and under revision. Case Presentation: Six cases of neonatal intestinal obstruction secondary to the annular pancreas diagnosed, operated on, and involved in our study. Age, gender, maturity, age at referral, birth weight, clinical presentation, imaging findings, associated congenital anomalies, treatment, complications, and hospital stay were all studied. Polyhydramnios is found in 3 cases (50%). Down syndrome was diagnosed in one case. One patient has associated malrotation. Symptoms started earlier within the first 24 hours. Vomiting was bile stained in 4 cases (66.7%). Passing meconium, sometimes frequent, does not exclude the annular pancreas. Most patients show double bubbles sign on plain abdominal X-ray. All six neonates were treated with duodenoduodenostomy with excellent results. Survival was 100% and complications were minimum. Conclusion: The annular pancreas, although rare, is an important cause of neonatal duodenal obstruction. The accurate diagnosis is usually performed during laparotomy. Vomiting may contain bile or not, furthermore, passing meconium does not exclude this condition. The best and the excellent surgical option is diamond duodenoduodenostomy. This case series might be added to the registered cases of the annular pancreas to standardize the method of diagnosis and to define the best management.
Annular Pancreas in Children: A Decade of Experience
The Eurasian Journal of Medicine, 2010
Objective: Annular pancreas is an uncommon cause of duodenal obstruction in children. In this study, the clinical, radiological, and prognostic fi ndings related to this disorder over a 12-year review period were analyzed. Materials and Methods: A retrospective review of 22 patients with annular pancreas who were treated with surgical repair between April 1998 and February 2010 was performed at two diff erent pediatric surgical units. Presenting symptoms, associated anomalies, radiological fi ndings, the type of surgery performed, postoperative outcomes, and complications were analyzed. Results: Twenty-two patients were identifi ed. Thirteen of the 22 patients (59.1%) were born prematurely, 11 patients (50%) had low birth weight, 2 patients (9.1%) had very low birth weight and 1 patient (4.5%) had extremely low birth weight. The mean birth weight was 2285.23±675.12 g. (970-3300). All patients presented with vomiting, which was bilious in nine (40.9%). Nine patients (40.9%) had chromosomal anomalies. Corrective surgery consisted of duodenoduodenostomy in 9 patients (40.9 %), duodenojejunostomy in 9 patients (40.9%), and gastrojejunostomy in 4 patients (18.1%). Fourteen of the 22 patients have survived (63.6%). The causes of death were combinations of sepsis, pneumonia, brain hemorrhage, and cardiac anomaly. Conclusion: Infants with annular pancreas associated with duodenal obstruction were often born prematurely and/or had low birth weights; many had cardiovascular anomalies. Annular pancreas associated with duodenal obstruction correlated strongly with the trisomy 21 karyotype among the chromosomal anomalies, as did duodenal atresia. The oral feeding tolerance time was nearly the same for all patients regardless of the surgical procedure used.
Annular pancreas – a rare cause of gastric obstruction in an 82-year-old patient
Annals of The Royal College of Surgeons of England, 2005
A nnular pancreas is an uncommon and rarely reported congenital anomaly and thus is rarely suspected. The pancreas is normally formed from the fusion of the dorsal and ventral pancreatic buds between the first 4-8 weeks of embryonic life. Annular pancreas is formed due to failure of the ventral bud to rotate and elongates to encircle the early part of the duodenum. It is one of the few medical conditions which can present itself in a wide range of clinical severities and can affect neonates to the elderly, thereby making the diagnosis difficult.