X-RAY FINDINGS IN THE PEDIATRIC SURGICAL EMERGENCIES

(10) ANNULAR PANCREAS AND MALROTATION OF INTESTINE

Abstract

The case of complete duodenal obstruction with an annular pancreas was a ten-day-old premature boy who was delivered of a hydramniotic mother. He had a history of bilious vomiting since the first day of life. The upright scout film of the abdomen showed “double bubble”. The contrast enema had ruled out the malrotation of the colon. A congenital intrinsic atresia of the duodenum was suspected, however, a duodenal obstruction due to an annular pancreas was confirmed at surgery. A duodenojejunostomy was carried out with complete success.
The case of duodenal stenosis due to malrotation of intestine was a four-month-old boy. He started to vomit intermittently from the third day of life. The vomiting was cyclic in nature, but he failed to gain nomal weight. The flat film of the abdomen showed dilated stomach and proximal duodenum with a small amount of intestinal gas shadow. A barium enema examination revealed the cecum positioned in the mid-abdomen, and the child was operated upon for the diagnosis of duodenal stenosis due to malrotation of the intestine. A peritoneal band crossing the duodenum and attaching the ascending colon to the posterolateral abdominal wall was divided and appendectomy was accompanied. His postoperative course was uneventful.