CASE REPORT   

Chirurgia 2017 October;30(5):176-9

DOI: 10.23736/S0394-9508.16.04641-6

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

A rare presentation of synchronous annular pancreas and intestinal malrotation

Amrollah SALIMI ¹ ✉, Abolfazl IRANIKHAH ², Seyed S. EFTEKHARI ³, Sara SHAHMORADI ³, Shervin RASHIDINIA ³

¹ Department of Pediatric Surgery, Hazrat-e-Masumeh Pediatrics Hospital, Qom University of Medical Sciences, Qom, Iran; ² Department of Pediatric Gastroenterology, Hazrat-e-Masumeh Pediatrics Hospital, Qom University of Medical Sciences, Qom, Iran; ³ Student Research Committee, Qom University of Medical Sciences, Qom, Iran

Since concomitance of annular pancreas (AP) and intestinal malrotation is a rare condition, we aimed to report a missed patient with a combination of annular pancreas and malrotation. The patient is a 10-month-old girl with non-bilious vomiting, which was occurring several times a week. Over four days prior to admission, severity of emesis was increased to several times a day. The patient presented with moderate to severe dehydration, failure to thrive and severe anemia to our department. Abdominal examination was unremarkable, howbeit, upper GI series demonstrated duodenal stenosis due to intestinal malrotation. Intra-operatively, we found a combination of annular pancreas with intestinal malrotation, which were treated by duodeno-duodenostomy and Ladd’s procedure, respectively. By this we meant to report a rare combination of AP with intestinal malrotation who was missing for 8 months by anti-reflux agents’ therapy, and hence, to issue the importance of proper diagnosis, quick referring and performing early intervention.

KEY WORDS: Annular pancreas - Vomiting - Dehydration