Annular pancreas with duodenal stenosis and intestinal malrotation in two years girl: A case report

Objective – To describe a rare case of a combination of annular pancreas with malrotation in early childhood. Case report – The patient is 2 year old aged girl with persistent non-bilious vomiting. She was vomiting several times a week, and over the ten days prior to presentation as many as several times a day. Upon presentation, the patient had an unremarkable abdominal exam with no abdominal pain. An upper gastrointestinal study showed extreme dilatation of the stomach and the duodenal bulb, and an abdominal computer tomography scan revealed an annular pancreas. Intra-operatively we find an annular pancreas and treated it by duodeno-duodenostomy, while the intestinal malrotation was treated by Ladd’s procedure. Conclusion – Annular pancreas is a rare congenital anomaly which in childhood is related to duodenal atresia or stenosis and often affiliated with intestinal malrotation.