Symptomatic annular pancreas in newborns.

BACKGROUND: The pancreas exhibits various types of anomalies, includingaplasia, dysplasia, pancreatic cysts, duplication, and ectopia, of which the most common is annular pancreas.This study describes the characteristic features of 7 cases of annular pancreas diagnosed during exploration.MATERIAL/METHODS:Seven newborns undergoing surgery for annular pancreas from 1990 to 1998 were analyzed. The cases wereevaluated according to birth weight, sex, symptoms, methods of diagnosis, associated anomalies, and surgicaltreatment modalities.RESULTS: The mean birth weight of the patients was 2385 +/- 1002 g, the mean gestationalage was 37.5 +/- 3.1 weeks. Four patients (42.8%) had associated anomalies, including intestinal malrotation(42.8%), intrinsic duodenal obstruction (28.5%), trisomy 21 karyotype (14.2%), cardiac malformation (14.2%),and Meckel's diverticulum (14.2%). Surgical treatment included duodenoduodenostomy (DD) in four patientsand DD plus tapering enteroplasty (TE) plus placement of transanastomotic jejunal tube (TJT) in threepatients.CONCLUSIONS: Infants with annular pancreas associated with duodenal obstruction are generallypremature or small for their gestational age. The symptoms observed in annular pancreas are related notonly to extrinsic compression of the ectopic tissue, but also the duodenal stenosis associated with thismalformation. Annular pancreas is most commonly associated with intestinal malrotation. It does not correlateas strongly with trisomy 21 karyotype as do the duodenal atresias, and oral feeding tolerance time isnearly the same between the DD and DD+TE+TJT groups.

Keywords: Abnormalities, Multiple, Infant, Newborn, Karyotyping, Pancreas