Annular pancreas in China: 9 years' experience from a single center
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Published on: February 9, 2024
DengLiang Wang1, Quan Kang2, ShuJun Shi1
1Department of Hepatobiliary Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China.
Insights
Annular pancreas (AP) in children often presents with symptoms in the neonatal period and is linked to low birth weight. Surgical repair is the definitive diagnostic and treatment approach for AP.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Neonatology
Background:
- Annular pancreas (AP) is a congenital anomaly requiring surgical intervention.
- Understanding the clinical profile of AP is crucial for timely diagnosis and management.
- This study reviews a significant cohort of pediatric AP cases.
Purpose of the Study:
- To summarize the clinical characteristics, diagnosis, treatment, and prognosis of 152 children with annular pancreas.
- To analyze presenting symptoms, birth weight, associated anomalies, and surgical outcomes.
- To highlight the diagnostic and therapeutic role of surgery in AP.
Main Methods:
- Retrospective review of 152 pediatric patients with annular pancreas.
- Surgical repair performed between January 2009 and August 2017.
- Analysis of clinical data including symptoms, birth weight, imaging, and surgical procedures.
Main Results:
- 152 patients (82 males, 70 females) were identified.
- Children with AP exhibited lower average birth weight, with significant percentages of low birth weight infants.
- 100 (66%) presented neonatally; 43 (28%) had prenatal duodenal obstruction diagnosis.
- All patients underwent open laparotomy and were discharged successfully.
Conclusions:
- Annular pancreas commonly manifests symptoms in the early neonatal period.
- Low birth weight is associated with AP, potentially due to impaired nutrient absorption and insulin secretion.
- While imaging aids, surgical intervention remains the definitive method for diagnosing and treating annular pancreas.
Abstract:
To summarize the clinical characteristics, diagnosis, treatment and prognosis among 152 children with annular pancreas (AP). A retrospective review of 152 patients with AP who were treated with surgical repair between January 2009 and August 2017 was performed at our pediatric surgical units. Presenting symptoms, birth weight, radiological findings, associated anomalies, the type of surgery performed were analyzed. (1) 152 patients were identified, out of which 82 were males, and 70 were females; (2) the average birth weight of children with AP was less than that of healthy newborns. The birth weights of 5.4% premature infants were less than 1500 g; the birth weight of 17% full-term infants, 69% premature infants and 50% post-term infants were less than 2500 g. (3) 100 (66%) patients presented symptoms during neonatal period and 43 (28%) patients had duodenal obstruction diagnosed by prenatal ultrasound scan. (4) All cases were managed surgically by open laparotomy, and all patients were duly discharged. AP most commonly presents symptoms in early neonatal period. Infants with AP are associated with a higher rate of low birth weight, and it was because swallowed amniotic fluid could not be absorbed and impaired insulin secretion caused by abnormal pancreas. Ultrasonography, abdominal plain film and upper gastrointestinal series (UGI) are helpful, but cannot make the diagnosis, and surgery is the only effective way to diagnose and treat AP.
