Multiple associated anomalies in a single patient of duodenal atresia: a case report

Mirza, Bilal; Ijaz, Lubna; Saleem, M.; Sheikh, Afzal

doi:10.1186/1757-1626-1-215

Cited by 13 publications

(14 citation statements)

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“…Although presence of Down syndrome in patients of duodenal atresia does not affect survival, the presence of multiple anomalies may alter the final outcome. [5,9] In the current era, majority of cases are diagnosed in antenatal period but in our series only 2 patients had antenatal diagnosis as most of the obstetrics and anomaly scan are still being done by the treating obstetrician thus missing the findings of CDO.…”

Section: Resultsmentioning

confidence: 74%

“…[6] In more than half of the patients with duodenal atresia, associated anomalies and syndromes are present. Down syndrome is present in 30% of cases, malrotation in 20%, and congenital heart diseases in 20% of cases; nevertheless, other congenital anomalies of alimentary tract are also present in these patients [9]. In 2/3rd patients, the associated anomalies occur in isolation, whereas multiple anomalies occur in 1/3rd of patients.…”

Section: Resultsmentioning

confidence: 99%

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Congenital Duodenal Obstruction in Neonates: Over 13 Years’ Experience from a Single Centre

Kumar¹,

Kumar²,

Pandey³

et al. 2016

J Neonat Surg

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Aim: To study the prevalence of associated anomalies with neonatal duodenal obstruction and factors impacting short-term survival. Material and methods: Records of 31 neonates with neonatal duodenal obstruction could be retrieved and analyzed for a 13.5-year-period (October 2003-May 2016). M:F ratio was 1.58:1. The mean birth weight was 2.15 kg; 12 patients were preterm. Etiologies included duodenal atresia (n=23), duodenal web (n=8) and malrotation of gut (n= 6). Results: Associated anomalies were seen in 19/31: Down's syndrome (n=6), anorectal malformation (ARM) (n=5), annular pancreas (n=5), cardiac anomalies (n=4), esophageal atresia with trachea-esophageal fistula (EA with TEF) (n=3). Mortality in the series was 22.5%; 5 deaths and 2 patients left against medical advice in moribund state (hidden mortality). Mortality in associated anomalies group was 5/19; and 2/12 in the no anomalies group, though this difference was not statistically significant (p=0.676). Similarly, low birth weight (LBW) did not have impact on survival (p=0.639) but preterm status had highly significant p value (<0.001). Conclusion: Duodenal atresia was the commonest cause of neonatal duodenal obstruction. Associated anomalies were noted in 61% patients, Down's syndrome being the most frequent. These anomalies did not have any significant impact on the survival, nor did LBW. Preterm status had significant impact on prognosis.

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Section: Resultsmentioning

confidence: 74%

Section: Resultsmentioning

confidence: 99%

Congenital Duodenal Obstruction in Neonates: Over 13 Years’ Experience from a Single Centre

Kumar¹,

Kumar²,

Pandey³

et al. 2016

J Neonat Surg

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“…Long-term problems may also occur because of other structural or chromosomal anomalies, the most common of which is trisomy 21 [18]. Duodenal atresia and stenosis, intestinal malrotation, and trisomy 21 can be found in combination with annular pancreas at a rate of 10-20%.…”

Section: Discussionmentioning

confidence: 99%

Annular Pancreas in Children: A Decade of Experience

Yiğiter

Yildiz

Firinci

et al. 2010

EAJM

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Objective: Annular pancreas is an uncommon cause of duodenal obstruction in children. In this study, the clinical, radiological, and prognostic fi ndings related to this disorder over a 12-year review period were analyzed. Materials and Methods:A retrospective review of 22 patients with annular pancreas who were treated with surgical repair between April 1998 and February 2010 was performed at two diff erent pediatric surgical units. Presenting symptoms, associated anomalies, radiological fi ndings, the type of surgery performed, postoperative outcomes, and complications were analyzed.Results: Twenty-two patients were identifi ed. Thirteen of the 22 patients (59.1%) were born prematurely, 11 patients (50%) had low birth weight, 2 patients (9.1%) had very low birth weight and 1 patient (4.5%) had extremely low birth weight. The mean birth weight was 2285.23±675.12 g. (970-3300). All patients presented with vomiting, which was bilious in nine (40.9%). Nine patients (40.9%) had chromosomal anomalies. Corrective surgery consisted of duodenoduodenostomy in 9 patients (40.9 %), duodenojejunostomy in 9 patients (40.9%), and gastrojejunostomy in 4 patients (18.1%). Fourteen of the 22 patients have survived (63.6%). The causes of death were combinations of sepsis, pneumonia, brain hemorrhage, and cardiac anomaly. Conclusion:Infants with annular pancreas associated with duodenal obstruction were often born prematurely and/or had low birth weights; many had cardiovascular anomalies. Annular pancreas associated with duodenal obstruction correlated strongly with the trisomy 21 karyotype among the chromosomal anomalies, as did duodenal atresia. The oral feeding tolerance time was nearly the same for all patients regardless of the surgical procedure used.

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“…Approximately 30% of trisomy 21 are associated with duodenal abnormalities. 4,6 The association with congenital diaphragmatic hernia is rare with only one previous case reported. 7 The diaphragm is formed by the septum transversum, pleuroperitoneal membrane, dorsal mesentery of the esophagus, and body wall.…”

Section: Discussionmentioning

confidence: 99%

Duodenal Stenosis with Diaphragmatic Hernia—A Rare Combination—Delayed Diagnoses with Barium Study

Ananthasivan

Rawat

Reddy

et al. 2019

Journal of Gastrointestinal and Abdominal Radiology

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Duodenal stenosis is part of a spectrum of disorders due to non-cannulization of the fetal gut lumen occurring in 11 to 13 weeks of fetal life. The diagnosis is often made in the neonatal period owing to bilious vomiting. The authors present a case of a 9-year-old boy who was diagnosed by an upper gastrointestinal study that showed a hugely dilated stomach filled with food residue and a dilated first part of the duodenum with an abrupt narrowing in the second part of the duodenum in keeping with duodenal stenosis. There was no associated malrotation (a known association), but the delayed images showed a surprising finding of herniation of large bowel loops into the thorax suggestive of a congenital diaphragmatic hernia (Bochdalek type). Both these findings were confirmed on surgery, and the patient underwent duodenoduodenostomy and diaphragmatic hernia repair and is doing well on follow-up. This case is unusual due to the rare association of duodenal stenosis with congenital diaphragmatic hernia and delayed diagnosis. Both these pathologies most often present in the neonatal period, and delayed diagnosis is most often seen with associated trisomy 21 that was not the case in our patient.

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Multiple associated anomalies in a single patient of duodenal atresia: a case report

Abstract: Background: Duodenal atresia is a common cause of intestinal obstruction in neonates. It is associated with other congenital anomalies like Down's syndrome, annular pancreas etc.

Cited by 13 publications

References 5 publications

Congenital Duodenal Obstruction in Neonates: Over 13 Years’ Experience from a Single Centre

Congenital Duodenal Obstruction in Neonates: Over 13 Years’ Experience from a Single Centre

Annular Pancreas in Children: A Decade of Experience

Duodenal Stenosis with Diaphragmatic Hernia—A Rare Combination—Delayed Diagnoses with Barium Study

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