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Annular pancreas in children: a recent decade's experience
Juan Carlos Jimenez1, Sherif Emil, Yale Podnos
1Division of Pediatric Surgery, University of California, Irvine Medical Center, Orange, CA 92868-3298, USA.
Journal of Pediatric Surgery
|November 18, 2004
Summary
Annular pancreas causes duodenal obstruction in children, often presenting in the first week of life. Surgical treatment, typically duodenoduodenostomy, leads to excellent outcomes despite associated anomalies.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Anomalies
Background:
- Annular pancreas is a rare congenital anomaly.
- It can lead to significant duodenal obstruction in infants and children.
- Understanding its clinical presentation and outcomes is crucial for effective management.
Purpose of the Study:
- To characterize the clinical, radiologic, and prognostic features of annular pancreas.
- To review a decade of patient data from two tertiary pediatric surgical centers.
- To evaluate treatment strategies and outcomes for pediatric annular pancreas.
Main Methods:
- Retrospective review of annular pancreas cases (1993-2002).
- Analysis of patient demographics, symptoms, associated anomalies, and surgical procedures.
- Evaluation of postoperative outcomes, including feeding tolerance and complications.
Main Results:
- Sixteen patients with annular pancreas were identified.
- Most presented with nonbilious vomiting and partial duodenal obstruction within the first week of life.
- Duodenoduodenostomy was the most common surgical procedure, with all patients surviving and achieving full enteral feeding.
Conclusions:
- Annular pancreas causes preampullary duodenal obstruction, frequently partial.
- Duodenoduodenostomy is the recommended surgical approach.
- Prognosis is excellent, even with co-occurring chromosomal or major congenital anomalies.