Annular Pancreas: Insights Into the Diagnosis of a Rare Anatomical Malformation in Pediatric Patients.

Annular pancreas is a rare congenital abnormality, detected in both pediatric and adult patients. Normally, the pancreas arises from the fusion of two endodermal buds of the caudal foregut, the dorsal and ventral pancreatic buds, during the first weeks of gestation. However, defects in embryonic development can lead to the formation of an annular pancreas. Being an uncommon clinical entity, a high level of suspicion is crucial for early diagnosis. We present a case of an annular pancreas in a neonate who was initially referred to our department with a prominent diagnosis of esophageal atresia. Preoperative ultrasound assessment indicated duodenal obstruction, raising suspicion of an annular pancreas, which was further confirmed by saline-aided ultrasound examination. Hence, duodenal bypass was performed. This report aims to present the diagnostic approach to this anatomical anomaly in pediatric patients and highlight the role of saline-aided ultrasound examination in approaching an accurate diagnosis, without the adverse effects of contrast medium administration or ionizing radiation.