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Peer-reviewedCC BY-NC-SAAfrican Journal of Paediatric Surgery

Annular Pancreas in Neonates; Case Series and Review of Literatures

  • Haithem Hussein Ali Almoamin1
  • Sadik Hassan Kadhem2,3
  • Ansam Mahmood Saleh4,5,6
6 affiliations
  1. 1Department of Surgery, University of Basrah, Al-Zahraa College of Medicine, Consultant, Basrah Children Specialty Hospital, Iraq
  2. 2Department of Surgery , University of Basrah , Al-Zahraa College of Medicine , Consultant , Basrah Children Specialty Hospital , Department of Surgery ,
  3. 3Department of Surgery, University of Basrah, Al-Zahraa College of Medicine, Basrah Children Specialty Hospital, Iraq
  4. 4Basrah Children Specialty Hospital , Iraq
  5. 5University of Basrah , Al-Zahraa College of Medicine , Basrah Children Specialty Hospital , Department of Paediatric ,
  6. 6Department of Paediatric, Basrah Children Specialty Hospital, Iraq
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Abstract

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.

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Cite

BibTeXRIS
BibTeX
@article{almoamin2026annular,
  title = {{Annular Pancreas in Neonates; Case Series and Review of Literatures}},
  author = {Haithem Hussein Ali Almoamin and Sadik Hassan Kadhem and Ansam Mahmood Saleh},
  journal = {African Journal of Paediatric Surgery},
  year = {2026},
  month = may,
  doi = {10.67481/ajps.v19i2.1025},
  url = {https://doi.org/10.67481/ajps.v19i2.1025},
  note = {CC BY-NC-SA},
}
RIS
TY  - JOUR
TI  - Annular Pancreas in Neonates; Case Series and Review of Literatures
AU  - Haithem Hussein Ali Almoamin
AU  - Sadik Hassan Kadhem
AU  - Ansam Mahmood Saleh
PY  - 2026
DA  - 2026/05/26
JO  - African Journal of Paediatric Surgery
DO  - 10.67481/ajps.v19i2.1025
UR  - https://doi.org/10.67481/ajps.v19i2.1025
AB  - 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.
SN  - 0189-6725
SN  - 0974-5998
ER  -