A Rare Cause of a Congenital Duodenal Obstruction in The Newborn Period with Nonbilious Vomiting: Annular Pancreas

Yıl 2018, Cilt: 2 Sayı: 2, 186 - 191, 31.08.2018

Zühal Örnek , Duygu Tatlı Uçarcı

Öz

The various causes of congenital duodenal obstruction (CDO) in the
newborn infants are well known but a spesific radiologic diagnosis
is difficult to establish. CDOs are classified as extrinsic and intrensic.
The annuler pancreas (AP) is involved in extrinsic causes, and is
frequently recognised during operation. The annulus is usually
consists of a band of pancreatic tissue that completely surrounds the
second part of the duodenum. We will describe AP, completely
encircled the first portion of the duodenum in the newborn period as
a rare cause of CDO with nonbilious vomiting, jaundice and discuss
the diagnostic strategies and management.

Anahtar Kelimeler

Nonbilious, Congenital Duodenal Obstruction, Annular Pancreas

Nonbilious Kusma ile Yenidoğan Döneminde Konjenital Duodenal Obstrüksiyonun Nadir Bir Nedeni: Annüler Pankreas

Öz

Yenidoğan bebeklerde konjenital duodenal obstrüksiyonun (CDO)
çeşitli nedenleri iyi bilinmektedir, ancak spesifik bir radyolojik tanı
koymak zordur. CDO'lar ekstrinsik ve intrenik olarak sınıflandırılır.
Annuler pankreas (AP) ekstrinsik nedenlere karışır ve operasyon
sırasında sıklıkla fark edilir. Anulus genellikle duodenumun ikinci
bölümünü tamamen çevreleyen bir pankreatik doku bandından
oluşur. Yenidoğan döneminde duodenumun ilk bölümünü tamamen
çevreleyen, noninvaziv kusma ve sarılık ile birlikte CDO'nun nadir
bir nedeni olarak AP'yi, tanımlayacağız ve tanı stratejilerini ile
yönetimini tartışacağız.

Anahtar Kelimeler

Nonbilious, Konjenital Duodenal Obstrüksiyon, Annüler Pankreas

Kaynakça

• 1. Tieddmann F. Uber die Verschiedenheiten des Ausfuhrungsgangs der Bauchspeicheldruse bei den Menschen und Saugetieren. Dtsch Arch Physiol. 1818; 4:403.
• 2. Millar AJW, Rode H, Cywes S. Intestinal atresia and stenosis. In: Ashcraft KW, editör. Pediatric Surgery. 3rd ed. Philadelpdia WB Saunders; 2000, 406-424.
• 3. Miyano T. The pancreas. In: O’neill JA Jr, Rowe MI, Grosfeld JL, Fonkalsrud EW, Coran AG, editors. Pediatric surgery, 5th ed. Mosby Year Book, St Louis, 1998;1527–44.
• 4. Staffer UG. Schwoebel M. Duodenal atresia and stenosis-annular pancreas. In: O'Neil JA Jr, Rowe MI, Grosfeld JL, Fonkalsrud EW, Coran AG, editors. Pediatric Surgery. 5th ed. Philadelphia Mosby Year Book; 1998,1133- 43.
• 5. Ladd WE. Congenital duodenal obstruction. Surgery 1937; 1: 878–85
• 6. Cunha JE, de Lima MS, et al. Unusual clinical presentation of annular pancreas in the adult. Pancreatology 2005; 5: 81-5.
• 7. Hamm M, Röttger P, Fiedler C. Pancreas anulare as a rare differential diagnosis of duodenal stenosis in adulthood. Langenbecks Arch Chir 1997;307-10.
• 8. Baggott BB, Long WB. Annular pancreas as a cause of extrahepatic biliary obstruction. Am J Gastroenterol 1991; 86: 224-6.
• 9. Shan YS, Sy ED, Lin PW. Annular pancreas with obstructive jaundice: beware of underlying neoplasm. Pancreas 2002;25:314-6.
• 10. Bouassria, A. , Elbouhaddouti, H. , Mouaqit, O. , Benjelloun, E. , Ousadden, A. , Mazaz, K. and Taleb, K. Annular pancreas producing duodenal obstruction: A case report. Open Journal of Gastroenterology 2013;3:202-204.
• 11. Siegel MJ. Adrenal glands, pancreas, and other retroperitoneal structures. In: Siegel M, editör. Pediatric Sonography. Philadelphia Lippincott Williams & Wilkins, 2002:475-527.
• 12. Poki HO, Holland AJ, Pitkin J. Double bubble, double trouble. Pediatr Surg Int 2005;21(6):428–31.
• 13. Imamoglu M, Cay A, Sarihan H, Sen Y. Rare clinical presentation mode of intestinal malrotation after neonatal period: Malabsorption-like symptoms due to chronic midgut volvulus. Pediatr Int 2004; 46: 167-70.
• 14. Yoshizato T, Satoh S, Taguchi T, Suita S, Nakano H. Intermittent ‘Double Bubble’ Sign in a Case of Congenital Pyloric Atresia. Fetal Diagn Ther 2002; 17: 334-8
• 15. Malone FD, Crombleholme TM, et al. Pitfalls of the 'double bubble' sign: a case of congenital duodenal duplication. Fetal Diagn Ther 1997; 12: 298-300.
• 16. Vaughn DD, Jabra AA, Fishman EK: Pancreatic disease in children and young adults: evaluation with CT. Radiographics 18:1171-1187, 1998.
• 17. Türkvatan A, Erden A, Türkoğlu M.A, Yener Ö. Congenital Variants and Anomalies of the Pancreas and Pancreatic Duct: Imaging by Magnetic Resonance Cholangiopancreaticography and Multidetector Computed Tomography. Korean J Radiol 2013;14(6):905-913.
• 18. Lin SZ. Annular pancreas. Etiology, classification and diagnostic imaging. Chin Med J 1989; 102: 368-72.
• 19. Hill ID, Lebenthal E. Congenital abnormalities of the exocrine pancreas, In: Pancreas: Pathology, Pathobiology and Disease 2nd ed, Go VLW, Dimagno EP, Gardner JD (Eds), et al, Raven Press, New York 1993: 1029-49.
• 20. Maker V, Gerzenshtein J, Lerner T. Annular pancreas in the adult: two case reports and review of more than a century of literature. Am Surg 2003; 69: 404-10.
• 21. Sencan A, Mir E, Günsar C, Akcora B. Symptomatic annular pancreas in newborns. Med Sci Monit 2002; 8: 434-7.
• 22. Zilberstein B, Sorbello MP, Orso IR, Cecconello I. Laparoscopic duodenal-jejunal bypass for the treatment of duodenal obstruction caused by annular pancreas: description of a surgical technique. Surg Laparosc Endosc Percutan Tech 2011; 21:60-4.
• 23. Shirkhoda A, Gore R: Anomalies and anatomic variants of the pancreas. In: Gore R, Levin M (eds): Textbook of Gastrointestinal Radiology. Philadelphia: Saunders, 2000:1754-1766.
• 24. Applebaum H, Lee SL, Puapong DP. In: Grosfeld Pediatric Surgery. Grosfeld JL, O'Neill JA Jr, Fonkalsrud EW, Coran AG, editors. Duodenal Atresia and Stenosis. Philadelphia, PA: Mosby Elsevier; 2006;1260–1268.
• 25. Grosfeld JL, Rescorla FJ. Duodenal atresia and stenosis: reassessment of treatment and outcome based on antenatal diagnosis, pathologic variance, and long-term follow-up. World J Surg 1993;17: 301- 9.
• 26. Merill JR, Raffensperger JG. Pediatric annular pancreas: Twenty years' experince. J Pediatr Surg 1976; 11: 921-5.
• 27. Bailey PV, Tracy TF Jr, Connors RH, Mooney DP, Lewis JE, Weber TR. Congenital duodenal obstruction: a 32-year review. Pediatr Surg. 1993;28(1):92-5.
• 28. Spigland N, Yazbeck S. Complications associated with surgical treatment of congenital intrinsic duodenal obstruction. J Pediatr Surg 1990; 25: 1127-30.