In 1978, your journal published the first report of dominant inheritance of annular pancreas [Jackson and Apostolides, 19781. To our knowledge, no other reports have appeared subsequently. We now provide brief details of a mother and son, both of whom presented in the neonatal period with gastrointestinal obstruction. The mother, the third child of healthy unrelated parents, 41 and 38 years old, underwent laparotomy at age 3 days. The descending duodenum was noted to "disappear," and the surgeon who performed the operation attributed this to an annular pancreas. No other abnormalities were noted. A duodenojejunostomy was performed and the infant made a full and uneventful recovery.This woman and her healthy unrelated husband recently had their first child, a boy, who also underwent laparotomy at age 3 days. The descending duodenum was found to be stenotic in association with an annular pancreas. No other abnormality was noted. A duodenoduodenostomy was performed, and the baby recovered rapidly.

Survival rates for infants undergoing surgical repair of oesophageal atresia with tracheo-oesophageal fistula (OA-TOF) have improved dramatically, but this condition remains associated with substantial morbidity. Most studies of patients following OA-TOF repair have concentrated on school-age and older people; whereas, the most hazardous period is infancy. We aimed to assess respiratory function in a group of infants following primary operative repair, and to relate the results to clinical findings during the first year of life. We studied 16 infants within 3 months of primary repair of OA-TOF. Measurements were made of maximum expiratory flow at functional residual capacity (VmaxFRC), thoracic gas volume (TGV) and airways resistance (Raw). Ten infants had tests repeated, usually to assess progress alongside continuing symptoms, or to ascertain improvement following additional surgery. Seven infants had essentially normal initial respiratory function tests, and six remained either symptom-free or developed only minor clinical problems. One infant subsequently developed stridor, with spontaneous improvement towards the end of the first year. The remaining nine infants had abnormal initial respiratory function tests: one was symptom-free at that time. The remainder developed respiratory and/or gastro-oesophageal symptoms. The functional abnormalities appeared to reflect the severity of the clinical problems encountered. We conclude that respiratory function testing in infants following OA-TOF repair may augment the value of clinical appraisal, help define postoperative respiratory status, and provide a general guide to likely clinical progress.

The performance of two types of respiration monitor was studied with regard to detection of central apnea and individual breaths. Each monitor detected central apnea more frequently than routine intermittent nursing observation. Both false alarms, when the monitor failed to detect breathing movements (false positive for apnea), and false respiration signals, when the monitor failed to detect the absence of breathing movements (false negative for apnea) were found. The latter sometimes prevented alarms. It was found that a trial period of monitoring under the controlled conditions described permitted adjustments to be made which eliminated or minimized these sources of error. This should be considered when the monitors are issued for use in the home. It is important that persons issuing the monitors be aware of their limitations.