Congenital Duodenal Obstruction: An Approach to Diagnosis

Abstract

53 neonates with congenital duodenal obstruction presented to Our Lady's Hospital for Sick Children over a consecutive 4-year period. Of these 53, 27 presented with intrinsic obstruction, and 26 with extrinsic obstruction. Diagnostic methods and features resulting in surgically proven diagnoses are discussed.

Congenital duodenal obstruction: causes and imaging approach

“…The age of presentation depends on the degree of obstruction. Duodenal atresia typically presents with the first feed [3,20], whereas partial duodenal obstructions present later [19]. The clinical presentation of late presenting cases is even more nonspecific and vague, and includes symptoms of abdominal pain, vomiting and diarrhea [20,22,23].…”

“…The initial abdominal radiograph is not always contributory [3,7,16,60,61] but can change management significantly if it demonstrates a true double bubble or multiple dilated bowel loops. Most other cases go on to upper gastrointestinal series (upper GI) for further characterization [62].…”

“…Congenital duodenal obstruction accounts for half of congenital bowel obstructions [1,2], with an incidence of 1 in 5,000 to 1 in 10,000 live births [3,4]. Complicating the management of patients with congenital duodenal obstruction is the fact that nearly half of these patients are premature [1,5] and greater than half are born with other major congenital anomalies, including cardiac defects, renal anomalies, esophageal atresia/tracheoesophageal fistula, biliary anomalies and trisomy 21 [1,[5][6][7][8][9][10].…”

Duodenal Atresia Associated with Apple Peel Atresia and Situs Inversus Abdominus: A Case Report

“…It is also common for duodenal atresia to be associated with other anomalies mainly congenital heart disease and Down's syndrome [1]. Our case had duodenal atresia, multiple atresias including apple peel type, and situs inversus abdominus.…”

“…Duodenal atresia is a relatively common anomaly with an estimated incidence of 1 in 3000 to 1 in 5000 live births [1]. It is also common for duodenal atresia to be associated with other anomalies mainly congenital heart disease and Down's syndrome [1].…”