Cai Peng, Zhu Zhenwei, Chen Jianlei, Chen Lulu, Pan Jiang, Zhi Wenxian, Zhu Jie, Wu Bin, Gu Zhicheng, Huang Shungen, Wang Jian
Department of Pediatric Surgery, Children's Hospital of Soochow University, Suzhou, China.
Medicine (Baltimore). 2018 Apr;97(17):e0583. doi: 10.1097/MD.0000000000010583.
Annular pancreas (AP) is recognized as a cause of duodenal obstruction in children, while children with Meckel's diverticulum (MD) are usually asymptomatic. Here we present a rare case with both AP and MD, which was identified by abdominal exploration during diamond-shaped duodenoduodenostomy.
A "double-bubble" sign was found by ultrasound at 35 week of pregnancy. After 39 weeks of pregnancy, the male patient was transferred to the Department of General Surgery, Children's Hospital of Soochow University because of a suspected duodenal stenosis.
Preoperative abdominal X-ray examination indicated "double-bubble" sign. AP was confirmed by exploratory surgery, with an MD located 30 cm above the ileocecal valve.
Diamond-shaped duodenoduodenostomy and a wedge resection of the intestine with end-to-end anastomosis were performed OUTCOMES:: The patient recovered and his appetite was good without vomiting.
Our experience demonstrates that abdominal exploration is essential for children with gastrointestinal malformations.
环状胰腺（AP）被认为是儿童十二指肠梗阻的一个病因，而患有梅克尔憩室（MD）的儿童通常无症状。在此，我们报告一例罕见的同时患有AP和MD的病例，该病例在菱形十二指肠十二指肠吻合术期间通过腹部探查得以确诊。
妊娠35周时超声检查发现“双泡”征。妊娠39周后，该男童因疑似十二指肠狭窄被转至苏州大学附属儿童医院普通外科。
术前腹部X线检查显示“双泡”征。经探查手术确诊为AP，在回盲瓣上方30厘米处发现一个MD。
实施了菱形十二指肠十二指肠吻合术及肠段楔形切除端端吻合术。
患者康复，食欲良好，无呕吐。
我们的经验表明，对于患有胃肠道畸形的儿童，腹部探查至关重要。
