Kimuras diamondshapedduodenoduodenostomy dsd is a known technique for the correction of congenital intrinsic duodenal obstruction. Vease tambien generalidades sobre las anomalias digestivas congenitas. Duodenal atresia and stenosis is a frequent cause of congenital, intestinal obstruction. Gastrointestinal disorders 1 jillian sullivan, md mscs associate professor of pediatrics. Prenatal ultrasonography makes possible an early diagnosis and treatment with better survival.
Congenital anomalies of the gastrointestinal tract. The vomiting is usually delayed until after the first feed and the abdominal distension is less obvious. Patients with completetype duodenal web present early in the neonatal period with duodenal obstruction whereas the fenestrated type may present late. In seven cases of congenital anomalies in adults, duodenal obstruction and peptic ulcer disease developed. Neonatos by leidy natali torres benitez 8 octubre, 2007 medicina general atresia y estenosis duodenal en neonatos. Congenital stenosis of the ileum in a 5monthold infant with intestinal obstruction syndrome refer to the atresia and stenosis together, differentiated only by the degree of obstruction of the lumen and, hence, the clinical presentation.
Based on these findings, the patient was operated on, and a hypertrophic pylorus and a duodenal web proximal to the ampulla of vater were found. Intestinal atresia is the main cause of obstruction in the digestive tract in newborn. Duodenal and intestinal atresia and stenosis clinical gate. To demonstrate developmental pathologies of the gastrointestinal tract git in children. Other congenital malformations are present in up to 50% of cases. Many babies with duodenal atresia have comorbidities. Other frequently described associated malformations include duodenal growth failure, annular pancreas see this term, which are particular. It had previously been suggested that the presence of gastric mucosa in the duodenum. Combined hypertrophic pyloric stenosis and duodenal web in. The individual components of the gi tract, including the duodenum, which connects the stomach and the intestines, and the intestines themselves, rearrange themselves and begin to settle into a position that will then remain unchanged for the rest of a persons life. Esophageal atresia is the most common gastrointestinal gi atresia. We inverted the direction of the duodenal incisions. Trisomy 21 should be particularly stressed as this can necessitate long term care and rehabilitation.
Kroneman2 summary a twomonthold female foal with duodenal stenosis is described. See the separate leaflet called stomach pain helicobacter pylori for more information. However, a few cases of duodenal atresia have been inherited as an autosomal recessive genetic trait. The modified kimuras technique for the treatment of. An association of congenital intrinsic duodenal obstruction causing partial duodenal obstruction in a patient with anorectal malformation is not described in literature. Duodenal atresia or stenosis nord national organization.
In duodenal gastric foveolar metaplasia the epithelium consists of gastric foveolartype columnar. In the adult, the condition is usually the result of some. Compression of the 3rd portion of the duodenum due to reasons such as extended bed rest, rapid weight loss, diseases such as pancreatitis or crohns disease that lead to inflammation and fibrosis in the mesenteric root. Babies with duodenal atresia may have other serious congenital anomalies which may alter outcome. A comprehensive analysis of 51 neonates with congenital intestinal atresia article pdf available in saudi medical journal 287.
Associated with congenital heart disease in 17% to. The aim of this study is to report children with congenital duodenal stenosis treated at our pediatric surgery unit, to find out the factors affecting the delayed presentation and its effect upon the prog nosis and to describe the management and outcome of those patients. The duodenal obstruction is more common than gastric obstruction. These ulcers can cause different symptoms, depending on where they are. Some congenital gi malformations, such as malrotation, have a very good outcome, whereas others. In the infant, signs such as vomiting, abdominal distension and constipation may occur shortly after birth or. Approximately 20 to 30% of infants with duodenal atresia are carriers of trisomy 21, and about 20 to 25% have cardiac anomalies. Duodenal obstruction is related to the orifice of the bile duct in 83% of the cases. Two cases of duodenal obstruction due to a congenital web. This is a rare presentation of congenital duodenal obstruction associated with downs syndrome in addition to seven cases previously reported in the english literature. There were two cases of congenital duodenal web, two of hypertrophic pyloric stenosis, two of annular pancreas, and one of a preduodenal portal vein. Chapter 62 duodenal atresia and stenosis felicitas eckoldtwolke afua a.
Congenital duodenal obstruction has, with appropriate surgical treatment, a good long and shortterm prognosis. Congenital duodenal web is a rare condition that usually presents early in life. Two syndromes in particular are associated with esophageal atresia. During the last few years a number of articles have appeared on the dilated duodenum of the adult, and this condition is now recognized as a definite clinical entity. This study aimed to analyze various factors affecting the outcome of these cases. Background a wide spectrum of congenital anomalies affects the git and is a cause of significant morbidity in children. We describe a case of delayed presentation of congenital in trinsic duodenal obstruction in a child with hightype anorectal malformations causing diagnostic dilemma. Obstruccion duodenal en pacientes pediatricos medigraphic. Gastric and duodenal ulcers are both types of peptic ulcers. Congenital duodenal obstruction is a frequent cause of intestinal obstruction in the newborn. Introduction congenital duodenal obstruction is one of the more common intestinal anomalies encountered by pediatric surgeons, occurring in 1 in 2500 5000 live births. Duodenal atresia has incidence of 1 in 10,000 live births reported in literatures. A peptic ulcer on the inside of the stomach lining is a gastric.
Preliminary investigation of the diagnosis of neonatal. Congenital malformations of the gastrointestinal tract. Differential diagnosis includes annular pancreas, malrotation, gastric or duodenal duplication, and preduodenal portal vein. The symptoms, signs and xray appearance give a rather definite picture. Duodenal atresia genetic and rare diseases information. Duodenal web refers to a small congenital obstructing membrane with a central pinhole aperture that constitutes a functional web. The department of general surgery, pediatric surgery unit, faculty of medicine, assiut university, assiut, egypt abstract backgroundpurpose. Even after surgical repair, babies may need to stay in nicu for several daysweeks and may require parenteral nutrition with associated complications. Laparoscopic repair of congenital duodenal obstruction. To emphasise the various imaging modalities available for the evaluation of the alimentary tract. Congenital duodenal web cdw is an uncommon cause of duodenal obstruction and endoscopic balloon dilatation has been reported in just eight pediatric cases to date. Plain abdominal radiographs can find intestinal obstruction, but they are not used for the diagnosis of sba. Ninety to 95% of patients survive without significant sequellae.
Late presentation of a congenital intrinsic duodenal. Congenital causes of duodenal ulcers in adults jama. From 1992 to 2006, 14 newborns were treated for duodenal atresia. Congenital duodenal stenotic diaphragm in a foal i. Reports also exist of congenital duodenal web diagnosed in adulthood 5 9. The radiograph demonstrates double bubble sign fig 5. Congenital duodenal web leading to partial obstruction. Prevention and management of duodenal polyps in familial. Most congenital gastrointestinal gi anomalies result in some type of intestinal obstruction, frequently manifesting with feeding difficulties, distention, and emesis at birth or within 1 or 2 days. Congenital duodenal obstruction is one of the most common congenital anomalies, accounting for almost half of cases of neonatal intestinal obstruction, its cause is either an intrinsic defect in the wall atresia, stenosis, or diaphragm or extrinsic compression due to malrotation, annular pancreas or preduodenal portal vein 1 2 3. More than a quarter of people in the uk become infected with h. The obstruction can be due to duodenal atresia, midgut volvulus or annual pancreas. Some congenital gi malformations, such as malrotation, have a very good outcome, whereas others, such as congenital diaphragmatic hernia, have a. Congenital duodenal obstruction associated with downs.
Congenital duodenal anomalies such as duplications and diverticula are usually asymptomatic, while annular pancreas and malrotation may manifest in the 1st decade of life. Duodenal atresia or stenosis is a rare congenital digestive disorder that usually occurs for no apparent reason sporadically. In 3052% of infants it is an isolated anomaly, but it is often associated with other congenital abnormalities. This report documents a new endoscopic management modality for congenital membranous stenosis in the third portion of the duodenum. Congenital duodenal atresia and stenosis is a frequent cause of intestinal obstruction and occurs in 1 per 5000 to 10,000 live births, affecting boys more commonly than girls.
Congenital obstruction of the duodenum accounts about one half of all the intestinal obstruction seen in the new born. Modification of the endoscopic management of congenital. Hesse sanjay krishnaswami introduction congenital duodenal obstruction may be due to intrinsic or extrinsic lesions. Longterm pressure of peristalsis against the stenotic segment of the duodenum may lead to distal stretching of the web, forming an intralu. Esophageal atresia pediatrics msd manual professional. Standard approaches to duodenal stenosis in newborns include a laparotomy with an.
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