title: Annular pancreas in children: a decade of experience.
abstract: OBJECTIVE
  Annular pancreas is an uncommon cause of duodenal obstruction in children. In this study, the clinical, radiological, and prognostic findings related to this disorder over a 12-year review period were analyzed.
  
  
  METHODS
  A retrospective review of 22 patients with annular pancreas who were treated with surgical repair between April 1998 and February 2010 was performed at two different pediatric surgical units. Presenting symptoms, associated anomalies, radiological findings, the type of surgery performed, postoperative outcomes, and complications were analyzed.
  
  
  RESULTS
  Twenty-two patients were identified. Thirteen of the 22 patients (59.1%) were born prematurely, 11 patients (50%) had low birth weight, 2 patients (9.1%) had very low birth weight and 1 patient (4.5%) had extremely low birth weight. The mean birth weight was 2285.23±675.12 g. (970-3300). All patients presented with vomiting, which was bilious in nine (40.9%). Nine patients (40.9%) had chromosomal anomalies. Corrective surgery consisted of duodenoduodenostomy in 9 patients (40.9 %), duodenojejunostomy in 9 patients (40.9%), and gastrojejunostomy in 4 patients (18.1%). Fourteen of the 22 patients have survived (63.6%). The causes of death were combinations of sepsis, pneumonia, brain hemorrhage, and cardiac anomaly.
  
  
  CONCLUSIONS
  Infants with annular pancreas associated with duodenal obstruction were often born prematurely and/or had low birth weights; many had cardiovascular anomalies. Annular pancreas associated with duodenal obstruction correlated strongly with the trisomy 21 karyotype among the chromosomal anomalies, as did duodenal atresia. The oral feeding tolerance time was nearly the same for all patients regardless of the surgical procedure used.
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine Ataturk University, Erzurum, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Yigiter
authors.affiliation: Department of Pediatric Surgery, Sisli Etfal Education and Research Hospital, Istanbul, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Yildiz
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine Ataturk University, Erzurum, Turkey.
authors.forename: Binali
authors.initials: B
authors.lastname: Firinci
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine Ataturk University, Erzurum, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Yalcin
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine Ataturk University, Erzurum, Turkey.
authors.forename: Akgun
authors.initials: A
authors.lastname: Oral
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine Ataturk University, Erzurum, Turkey.
authors.forename: Ahmet Bedii
authors.initials: AB
authors.lastname: Salman
keywords: Child; Duodenal obstruction; Pancreas