Rationale: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.Patient concerns: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.Diagnoses: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.Interventions:Diamond-shaped duodenoduodenostomy and a wedge resection of the intestine with end-to-end anastomosis were performedOutcomes:The patient recovered and his appetite was good without vomiting.Lessons:Our experience demonstrates that abdominal exploration is essential for children with gastrointestinal malformations.

Background: Enteric duplication is a congenital anomaly with varied clinical presentation that requires surgical resection for definitive treatment. Ileocaecal (IC) duplications are duplications located at the IC junction, not clearly identified in all the published series. The reported treatment is IC resection and ileocolic anastomosis. The purpose of our study was to present our experience in successfully resection of IC duplication by laparoscope, thus avoiding bowel resection in children. Materials and Methods: A retrospective review was conducted of medical records of 15 patients with diagnosis of IC duplication, treated in the Department of Paediatric Surgery of our hospital, within the period from November 2013 to September 2018. Results: Laparoscopic resection of IC duplication was successfully performed in all children without bowel resection. The operation time was 50–90 min (55 ± 10 min), and the post-operative hospitalization time was 5–7 days (average, 6 days). The 15 patients were followed up for 6–12 months (average, 10 months). No recurrence was found by abdominal ultrasound examination. The wound had small scars with good appearance of umbilicus. Conclusions: The laparoscopic approach allows for confirming the diagnosis and accurately defining the exact site of duplication, as well as for effective and safe treatment. Laparoscopic excision of IC duplication without bowel resection is a safe option and is worth promoting.

Introduction: Syndrome of the splenic flexure of the colon is caused by congenital splenic colon curvature with excessively high fixed points, a lengthy transverse colon, and a narrow splenic flexure angle. Clinical manifestations of this syndrome lack specificity. To date, the causes of the syndrome are poorly characterized. Syndrome of the splenic flexure of the colon usually occurs in elderly women, but it is extremely rare in children. Here we report a case of a child with syndrome of the splenic flexure of the colon. Presentation of case: A 14-year old female patient developed constipation and bloating two years ago and received conservative treatment at their local hospital. One week earlier, the patient again experienced abdominal pain, constipation, and abdominal distension. After failure in improving the symptoms, the patient was transferred to our hospital. Through the preoperative abdominal barium enema X-ray and CT scan, the patient was finally diagnosed with syndrome of the splenic flexure of the colon. A laparoscopy-assisted subtotal colectomy and anastomosis were subsequently performed. The resected specimens were ˜70 cm in length and ˜10 cm in diameter. Histopathology was performed on the surgically removed specimens.The patient is undergoing regular re-examinations and is recovering satisfactorily. Conclusion: For children with recurrent abdominal pain, bloating and constipation, a barium enema X-ray is recommended. Surgery is recommended if syndrome of the splenic flexure of the colon is considered. Highlights: