A newborn patient with both annular pancreas and Meckel's diverticulum

Abstract

Rationale:Annular pancreas (AP) is recognized as a cause of duodenal obstruction in children, while children with Meckel's diverticulum (MD) are usually asymptomatic. Here we present a rare case with both AP and MD, which was identified by abdominal exploration during diamond-shaped duodenoduodenostomy.Patient concerns:A “double-bubble” sign was found by ultrasound at 35 week of pregnancy. After 39 weeks of pregnancy, the male patient was transferred to the Department of General Surgery, Children's Hospital of Soochow University because of a suspected duodenal stenosis.Diagnoses:Preoperative abdominal X-ray examination indicated “double-bubble” sign. AP was confirmed by exploratory surgery, with an MD located 30 cm above the ileocecal valve.Interventions:Diamond-shaped duodenoduodenostomy and a wedge resection of the intestine with end-to-end anastomosis were performedOutcomes:The patient recovered and his appetite was good without vomiting.Lessons:Our experience demonstrates that abdominal exploration is essential for children with gastrointestinal malformations.

Annular pancreas in neonate patients

“…The literature mentions intestinal duplication, intestinal malrotation, and even Meckel's diverticulum. 5,8 There is also a strong association with Down syndrome. 9 In the case reported, however, the other malformation was a bone deformity in the sacral region, not usually associated with the annular pancreas.…”

A Case of Jejunal Atresia Associated With Heterotrophic Pancreas and Meckel’s Diverticulum

“…Other congenital abnormalities affiliated with the annular pancreas in children are well known, with Down's syndrome being the most common birth chromosomal anomaly, with a 10% to 30% occurrence [ 12 ]. In addition, cardiac deficiencies, bowel atresia, and small bowel anomalies have been linked to the annular pancreas.…”

“…In addition, cardiac deficiencies, bowel atresia, and small bowel anomalies have been linked to the annular pancreas. Regarding the infant in this case study, while Meckel’s diverticulum is known to be one of the most common congenital malformations, little is known about the potential relationship between the annular pancreas and Meckel's diverticulum, as well as infants who have both annular pancreas and Meckel's diverticulum [ 12 ].…”

Obstrucción duodenal debido a páncreas anular en etapa neonatal

“…El páncreas anular es una infrecuente anomalía congénita caracterizada por un anillo de tejido pancreático rodeando la porción descendente del duodeno (D2). Esta condición fue descrita por primera vez por Tiedemann en 1818 y denominada 50 años más tarde páncreas anular por Ecker en 1862 (1,2). Tiene una prevalencia dentro de las patologías del sistema gastrointestinal de 0.24 por cada 10,000 nacidos vivos según estudio de prevalencia de defectos congénitos del departamento de Risaralda-Colombia (3) y en el ámbito mundial tiene una prevalencia de 1 en 20,000 nacimientos (4).…”