Annular Pancreas with Meckel’s Diverticulum and Ladd’s Band in Neonate

Abstract

Annular pancreas is a rare congenital malformation consisting of pancreatic tissue surrounding the descending portion of the duodenum and induces intestinal obstruction. This is caused by incomplete rotation of the ventral pancreatic bud. In children, the annular pancreas is also associated with trisomy 21 and other congenital diseases such as Meckel’s diverticulum, intestinal, or cardiac malformations. Here we presented a rare case of the annular pancreas with Meckel’s diverticulum identified by the abdominal exploration of an 8-day-old girl who suffered from projectile bilious vomiting. A plain abdominal radiograph showed a ‘double-bubble sign’ with air in the stomach and duodenum, and the upper gastrointestinal series showed a dilated proximal duodenum, with partial obstruction of the descending duodenum. The exploration revealed an annular pancreas, Meckel’s diverticulum, and Ladd’s band without large bowel malrotation. Subsequently, she ate well and was discharged on the 27th hospital day.