Annular pancreas, severe tracheomalacia and bronchomalacia in a preterm boy with VACTERL association: VACTERL association includes vertebral anomalies, anal atresia, cardiac defects, tracheao-esophageal fistula, renal anomalies, and limb abnormalities. It is defined by the presence of at least three of these congenital malformations. The incidence has been estimated to be 1/10.000-1/40.000 live births. We report on a preterm infant with VACTERL presenting with respiratory complications due to the presence of severe tracheomalacia and bronchomalacia. He also had an annular pancreas.