Uncommon Causes of Pyloric and Duodenal Obstruction in Pediatric Population: Radiological and Surgical Correlation

Abstract

Background: Duodenal and pyloric obstruction in neonates and young children have diverse causes such as atresia, volvulus, and foreign body or may be extra-luminal obstruction. Aim of Study: To assess causes of pyloric and duodenal obstruction in pediatric population (other than CHPS) and determine the causes of obstruction radiologically and compare them with surgical data. Patients and Methods: Our study included 22 patients (12 boys and 10 girls), age range from 1 day to 6 years. This study was done on cases of pyloric and duodenal obstruction in newborns, infants and young children less than 6 years in the period from 2017 through 2019. Cases of Congenital Hypertrophic Pyloric Stenosis (CHPS) were excluded from the study. The clinical, radiological data were gathered and compared to each other. Results: The spectrum of causes of pyloric and duodenal obstruction was as follow: 4 cases of pyloric atresia, 5 cases with duodenal atresia, 3 cases with duodenal stenosis by incomplete web, one case with annular pancreas, 4 cases with midgut volvulus, one case with duodenal duplication cyst, 3 cases with foreign body obstruction and one case with trichobezoar. All cases were treated surgically to alleviate the obstruction. The radiological data were well correlated with surgical findings. Conclusion: Pyloric and duodenal obstruction in pediatric population has different causes. Radiological imaging could determine the cause of obstruction with good correlation with surgery.