Congenital duodenal obstruction

Abstract

Over the period 1980-1989, 49 patients with congenital duodenal obstruction due to duodenal atresia, duodenal stenosis or annular pancreas were treated. There were three deaths, all related to associated severe congenital anomalies and none related to surgery for duodenal obstruction; 78 per cent of the patients had associated congenital anomalies which, in some instances, complicated their management. Prenatal diagnosis by ultrasonography was made in 18 per cent of the patients and these patients had operations relatively earlier.

Congenital duodenal obstruction: causes and imaging approach

“…In the older child and adult, SMA syndrome typically presents with chronic nonspecific abdominal symptoms such as post-prandial pain, epigastric discomfort, vomiting and reflux, often surfacing or worsening following a period of weight loss [6,[53][54][55]. There are reports of SMA syndrome presenting in the neonatal period with emesis and poor weight gain, sometimes causing mild symptoms that progress to SMA syndrome as the child grows [58].…”

“…In the surgical series that separate duodenal webs from duodenal atresia, duodenal webs account for 10-31% of congenital duodenal obstructions [2,4,6,7,10,12]. On average, children present later in the neonatal period or infancy than with duodenal atresia, with 50% presenting after 1 month in one series [32] and a median age of presentation of 8 days in another series [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]. With improving operative technique and neonatal intensive care, survival ranges 90-95% and death is usually secondary to associated complex congenital heart disease [2,[5][6][7]10].…”

“…The frequency of each etiology of congenital duodenal obstruction varies widely among reported surgical case series [1,2,[5][6][7][8][10][11][12], with duodenal atresia being the most commonly attributed cause [1,2,5]. Less than 5% of children with congenital duodenal obstruction have a second distal duodenal, jejuno-ileal or colonic obstruction [1,13].…”

Prenatal Diagnosis of Annular Pancreas: Reliability of the Double Bubble Sign with Periduodenal Hyperechogenic Band

“…Based on all known literature records [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] , prenatal diagnosis of annular pancreas is usually done in those cases that are accompanied with remarkable duodenal obstruction, i.e. when a well-developed double bubble sign is present.…”