Background: The annular pancreas is a rare congenital disorder of the pancreas first recognized in 1818. It is believed to result from faulty rotation of the ventral pancreatic bud in its course around the posterior aspect of the duodenal anlage. The duodenum is encircled and might be obstructed by normal pancreatic tissue. The management of the annular pancreas is still developing and under revision. Case Presentation: Six cases of neonatal intestinal obstruction secondary to the annular pancreas diagnosed, operated on, and involved in our study. Age, gender, maturity, age at referral, birth weight, clinical presentation, imaging findings, associated congenital anomalies, treatment, complications, and hospital stay were all studied. Polyhydramnios is found in 3 cases (50%). Down syndrome was diagnosed in one case. One patient has associated malrotation. Symptoms started earlier within the first 24 hours. Vomiting was bile stained in 4 cases (66.7%). Passing meconium, sometimes frequent, does not exclude the annular pancreas. Most patients show double bubbles sign on plain abdominal X-ray. All six neonates were treated with duodenoduodenostomy with excellent results. Survival was 100% and complications were minimum. Conclusion: The annular pancreas, although rare, is an important cause of neonatal duodenal obstruction. The accurate diagnosis is usually performed during laparotomy. Vomiting may contain bile or not, furthermore, passing meconium does not exclude this condition. The best and the excellent surgical option is diamond duodenoduodenostomy. This case series might be added to the registered cases of the annular pancreas to standardize the method of diagnosis and to define the best management.

Inguinal hernia repair is one of the most frequently performed surgical procedure in pediatric patients. An inguinal hernia does not resolve spontaneously and must be repaired because of high risk of complications. The aim of this study is to determine epidemiologic index and complications of inguinal hernia in pediatric patients. This retrospective study was carried out in the Basrah Children Hospital. All patients who underwent surgeries for inguinal hernia from 2012 to 2014 were included in this study. Their hospital records were reviewed for age, sex, side of the hernia, presentation, wound infection, recurrence, and other complications. In this study, 877 children were included. 766 (87.3%) were boys and 111 (12.7%) were girls. Most common age of presentation is between 6 months to 6 years which compromise 54.6%. Right-side and left-side inguinal hernia was observed in 531 (60.5%) and 276 (31.5%) cases, respectively. Bilateral inguinal hernia was observed in 70 (8%) cases. One hundred forty eight (16.9%) children presented as emergencies with irreducible hernia. Emergency presentation was more in male gender and more in the first 6 months of life. Postoperative complication rate for elective was 3.2% and for emergency groups was 51.7%. In conclusion, most of the hernias involved male patients. Postoperative complications were observed in 51.7% of the emergency cases, so inguinal hernia in children should be operated as early as possible to avoid incarceration and to decrease post-operative complications.

Intussusception is a very rare cause of neonatal intestinal obstruction, particularly in preterm neonates. This rarity may lead to a significant delay in diagnosis. We present a case report of ileo-ileal intussusception occurring in a preterm neonate. Intussusception should be suspected in any neonate suffering from intestinal obstruction. Performing an abdominal ultrasound may confirm the diagnosis.