Neonatal Duodenal Obstruction Caused by Annular Pancreas in Two Mongoloid Children

ANNULAR PANCREAS, apparently due to the ventral primordium's failure to rotate as a whole, is a rare congenital anomaly. In view of this rarity, it is felt that report of 2 mongoloid patients in whom this anatomical defect caused neonatal duodenal obstruction would be of interest. Report of Cases Case1.—-On April 20, 1959, a 34-year-old Rh-positive, group AB, para 4, gravida 5, white housewife with Raynaud's disease gave birth to a 5-lb., 15-oz. (2.69 kg.) female infant. Polyhydramnios complicated the pregnancy. Examination of the infant revealed mongoloid facies, slight cyanosis, a high-pitched cry, a small oval head, a Grade 1 to 2 systolic murmur heard best in the right scapular region, an enlarged liver felt 3 fingerbreadths below the right costal margin, a palpable spleen, absent Moro reflex, and extreme flaccidity of the body. Shortly after birth the infant was placed in an incubator and oxygen was administered. Five