scholarly journals Laparoscopic repair of congenital duodenal obstruction is feasible even in small-volume centres

2016 ◽  
Vol 98 (8) ◽  
pp. 578-580 ◽  
Author(s):  
BJ MacCormack ◽  
JPH Lam
Keyword(s):  
Laparoscopic Repair ◽  
Duodenal Obstruction ◽  
Small Volume ◽  
Duodenal Atresia ◽  
Associated Anomalies ◽  
Extensive Experience ◽  
Intracorporeal Suturing ◽  
Congenital Duodenal Obstruction ◽  
Age At Surgery ◽  
Sick Children

INTRODUCTION It has been suggested that laparoscopic repair of congenital duodenal obstruction (CDO) should be restricted to a limited number of designated centres of expertise. After gaining extensive experience with intracorporeal suturing in other procedures, we evaluated the feasibility of this approach at the Royal Hospital for Sick Children (RHFSC; Edinburgh, UK). METHODS We conducted a retrospective review of all cases of CDO presenting to the RHFSC from 2012 to 2014. Cases were identified from our electronic database using standardised codes. Data comprised: gestation; birth weight; associated anomalies; patient age and weight at surgery; operative time; complications; postoperative course. RESULTS Five consecutive non-selected cases of isolated CDO were repaired laparoscopically, and all were carried out by the senior surgeon. The male:female ratio was 4:1. Corrected gestational age at surgery was 35–38 weeks, and the weight at surgery was 1.7–3.1 kg. None of our patients had significant associated anomalies. CONCLUSIONS The present study demonstrates the feasibility of laparoscopic repair of CDO in small-volume centres, and is the first report of laparoscopically managed congenital duodenal atresia in twins.

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

2016 ◽  
Vol 5 (4) ◽  
pp. 50 ◽  
Author(s):  
Parveen Kumar ◽  
Chiranjiv Kumar ◽  
Prince Raj Pandey ◽  
Yogesh Kumar Sarin
Keyword(s):  
Birth Weight ◽  
Duodenal Obstruction ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Duodenal Atresia ◽  
P Value ◽  
Associated Anomalies ◽  
Congenital Duodenal Obstruction ◽  
Impact On Survival ◽  
Duodenal Web

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 (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.

Laparoscopic Repair of Duodenal Atresia in a Low Birth Weight Neonate

2014 ◽  
Vol 80 (9) ◽  
pp. 834-835 ◽  
Author(s):  
Armando Rosales-Velderrain ◽  
Abraham Betancourt ◽  
Fuad Alkhoury
Keyword(s):  
Birth Weight ◽  
Gas Exchange ◽  
Laparoscopic Repair ◽  
Small Volume ◽  
Positive Pressure Ventilation ◽  
Duodenal Atresia ◽  
Positive Pressure ◽  
Knot Tying ◽  
Intracorporeal Suturing ◽  
Birth Weight Neonate

The small volume of the infant abdomen limits the application of laparoscopic procedures. We successfully repaired a duodenal atresia in a 2-kg female infant using a standard diamond-shaped anastomosis and intracorporeal suturing and knot-tying techniques. Anesthesia and positive pressure ventilation assured adequate gas exchange during pneumoperitoneum during the procedure.

CONGENITAL ATRESIA AND STENOSIS OF THE DUODENUM

PEDIATRICS ◽  
1969 ◽  
Vol 43 (1) ◽  
pp. 79-83
Author(s):  
Eric W. Fonkalsrud ◽  
Alfred A. deLorimier ◽  
Daniel M. Hays
Keyword(s):  
Congenital Malformations ◽  
Duodenal Obstruction ◽  
Duodenal Atresia ◽  
Operative Techniques ◽  
Congenital Atresia ◽  
Late Mortality ◽  
Congenital Duodenal Obstruction ◽  
American Academy Of Pediatrics ◽  
Associated Malformations ◽  
Major Congenital Malformations

A review is presented of 503 patients with congenital duodenal obstruction, compiled from 65 hospitals by the Surgical Section of the American Academy of Pediatrics. Four hundred eighty-seven patients underwent primary operative correction of the malformation with an overall early and late mortality rate of 36%. Complications from associated major congenital malformations were the leading cause of death. Many of these anomalies were potentially correctable had they been recognized and early treatment instituted. More than half of the infants with duodenal atresia had associated malformations. Thirty percent of the patients had Down's syndrome. End-to-side or side-to-side duodenoduodenostomy or jejunostomy are the most commonly used operative techniques for duodenal atresia. General anesthesia and tube gastrostomy are usually employed.

Congenital Duodenal Obstruction: Evaluation of 68 Cases

2021 ◽  
Author(s):  
Emel Çolak ◽  
Ayşenur Celayir
Keyword(s):  
Duodenal Obstruction ◽  
Associated Anomalies ◽  
Hospital Records ◽  
Cardiac Malformations ◽  
Congenital Duodenal Obstruction ◽  
Clinical Presentations ◽  
Hospitalization Period ◽  
Common Causes ◽  
The Mean ◽  
Associated Abnormalities

INTRODUCTION: Congenital duodenal obstruction, which is one of the most common causes of intestinal obstruction in neonates, gain importance in terms of associated anomalies. In this study, we aimed to review our experience with congenital duodenal obstruction cases operated in our clinic while evaluating the results of these patients. METHODS: All hospital records of neonates with congenital duodenal obstruction which had operated in our department between 2004 and 2017 were reviewed retrospectively. Patients were evaluated according to their demographic features, clinical presentations, associated anomalies, treatments and outcomes. RESULTS: During 13 years, 68 newborns (36 males, 32 females) with congenital duodenal obstruction were operated. The mean gestational age was 35.7±3.1weeks (28-44weeks), the mean birth weight was 2477±651.5 gram (1100–4100 gram) and 46 (67.7%) of them were premature. Associated abnormalities were detected in 37 neonates (54.4%); 16 of them (23.5%) had congenital cardiac malformations, and 13 of them (19.1%) had Down Syndrome. In neonates with associated abnormalities; the avarage period to start enteral feeding was 9.5±5.8 days (4-37days) and the mean hospitalization period was 25.6±26.2days (9-140days). These values were found 7.6±3.2 days (4-20days) and 17.5±13.7days (8-80days) respectively for the patients having no associated anomalies. Postoperative complications such as ileus, septicemia and nutritional intolerance were seen in 17 patients (25%); 3 of them (4.4%) need re-operation. While 63 patients (92.6%) were discharged on average 21.4±22 days (8-140 days); due to septicemia and severe congenital cardiac malformations 5 patients (7.4%) were died in 27.2±14.1 days (11-43days) postoperatively. The rate of septicemia was statistically significantly higher in patients with excitus than the ones who were discharged (p<0.001). DISCUSSION AND CONCLUSION: The presence of associated abnormalities in patients with congenital duodenal obstruction increases the risk of morbidity and mortality. Septicemia and severe congenital cardiac malformations adversely affect prognosis.

Factors affecting early mortality and morbidity in congenital duodenal obstruction: Summary of a 20-year experience

2016 ◽  
Author(s):  
Bahattin Aydogdu ◽  
Gulay Tireli ◽  
Oyhan Demirali ◽  
Unal Guvenc ◽  
Cemile Besik ◽  
...  
Keyword(s):  
Birth Weight ◽  
Duodenal Obstruction ◽  
Oral Intake ◽  
Duodenal Atresia ◽  
Early Mortality ◽  
Mortality And Morbidity ◽  
Factors Affecting ◽  
Cardiac Anomalies ◽  
Congenital Duodenal Obstruction ◽  
Time Of Operation

Abstract Purpose: In infants, the duodenum is the most frequently obstructed region of the gastrointestinal tract. The objective of the present study was to summarise the causes of early mortality and morbidity in infants with congenital duodenal obstruction (CDO). Methods: Data on a total of 94 patients with CDO diagnosed in our clinic, and treated surgically between January 1993 and December 2012, were studied retrospectively. Patients were divided into three groups in terms of diagnosis: annular pancreas (n = 45), duodenal atresia (n = 31), and duodenal web (n = 18). The groups were compared in terms of sex, birth weight, age at the time of operation, and morbidity and mortality rates. Results: Of the patients, 54 were males and 40 females, and the mean birth weight was 2,278 (range, 1,180-3,400) g. The average age at the time of the operation was 6.96 (range 1-38) days. The time to full oral intake postoperatively was 10.32 (range, 4-38) days. Additional anomalies were found in 61 (64.8%) cases. Early morbidity was most commonly associated with an anastomosis problem. Early mortality occurred in 6 (6.4%) cases, and the most common causes were sepsis and cardiac anomalies. Conclusions: Elimination of sepsis, cardiac anomalies, and anastomosis problems are critical to ensure continued reductions in infant mortality and morbidity caused by CDO.

scholarly journals Congenital Duodenal Obstruction, Situs Inversus Totalis, and Gastric Perforation in a Neonate

2017 ◽  
Vol 6 (2) ◽  
pp. 35 ◽  
Author(s):  
Rajat Piplani ◽  
Samir Kant Acharya ◽  
Deepak Bagga
Keyword(s):  
Situs Inversus ◽  
Duodenal Obstruction ◽  
Gastric Perforation ◽  
Duodenal Atresia ◽  
Situs Inversus Totalis ◽  
Contrast Study ◽  
Congenital Duodenal Obstruction ◽  
Duodenal Web ◽  
Lesser Curvature

We report a rare case of incomplete congenital duodenal obstruction (Type 1 duodenal atresia) in association with situs inversus totalis presenting with gastric perforation in a neonate. The infantogram was suggestive of perforation with air under diaphragm along with dextrocardia. On exploration, a pin point perforation at fundus near lesser curvature along with situs inversus was noted. Primary closure of gastric perforation was done. Patient was then discharged on full breast feeds but was readmitted with intolerance to feeds and recurrent bilious vomiting. Further, upper GI contrast study revealed partial duodenal obstruction. On re-exploration, duodenal web with central aperture was seen and duodeno-duodenostomy was done.

scholarly journals Clinical profile and predictors of outcome in congenital duodenal obstruction

2017 ◽  
Vol 4 (8) ◽  
pp. 2605 ◽  
Author(s):  
Sankkarabarathi Chandrasekaran ◽  
Anirudhan Asokaraju
Keyword(s):  
Duodenal Obstruction ◽  
Clinical Symptoms ◽  
Duodenal Atresia ◽  
Clinical Profile ◽  
Paediatric Surgery ◽  
Congenital Duodenal Obstruction ◽  
Broad Term ◽  
Long Term Follow Up ◽  
Cardiac Lesions ◽  
Feed Intolerance

Background: Congenital duodenal obstruction is a broad term that refers to a variety of disorders like duodenal atresia, duodenal stenosis, annular pancreas, duodenal membrane and preduodenal portal vein. The aim of this study was to analyse in detail the entire clinical profile of duodenal obstruction and to study the short-term outcome.Methods: A prospective descriptive study was conducted in the Department of Paediatric Surgery, Institute of child Health and Hospital for Children, Egmore, Chennai, among all babies with suspected duodenal obstruction based on clinical symptoms and subsequently proven by surgery from September 2013 to January 2015. Fifty babies were selected for this study based on the eligibity criteria.Results: Upper gastrointestinal contrast radiography is the gold standard investigation in diagnosing duodenal membrane with a hole. The type of surgery such as the duodenoplasty, duodenoduodenostomy or duodenojejunal anastomosis did not affect the post-op outcome.Conclusions: Long term follow up is warranted to know the actual incidence of requirement for redo procedure for feed intolerance. The presence of coexisting Down’s syndrome and congenital cardiac lesions increases the mortality rate in these children.

scholarly journals Potential Benefits of Laparoscopic Repair of Duodenal Atresia: Insights from a Retrospective Comparative Study

2019 ◽  
Vol 30 (01) ◽  
pp. 033-038
Author(s):  
Martin Sidler ◽  
Florin Djendov ◽  
Joe I. Curry ◽  
Simon Blackburn ◽  
Stefano Giuliani ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Laparoscopic Repair ◽  
Duodenal Atresia ◽  
Exact Test ◽  
Congenital Duodenal Obstruction ◽  
Postoperative Time ◽  
Potential Benefits ◽  
Group 5 ◽  
Retrospective Comparative Study ◽  
Open Versus

Abstract Introduction Congenital duodenal obstruction (CDO) repair can be performed open or laparoscopically. We aimed to determine the potential benefit of laparoscopic repair regarding tolerance of enteral feeding, postoperative pain, hospital stay, and complication rate. Materials and Methods In a single-center retrospective cohort study, we compared neonates with isolated CDO operated open versus laparoscopically from 2010 to 2019. No transanastomotic tubes were used, and anastomoses were created in a side-to-side fashion in all cases. An early feeding policy is applied for all cases operated at our institution. Statistical comparison was performed using the Mann–Whitney's test or Fisher's exact test where appropriate. Results Forty-one patients analyzed were similar regarding body weight, gestational age, and proportion of patients with trisomy 21. Median follow-up was 21 months. Four (20%) out of 20 laparoscopic procedures started laparoscopically were converted to open. Comparing the 21 open with the 16 laparoscopically completed patients, median anesthetic duration was shorter by 18% in the open versus laparoscopic completed group (218 vs. 179 minutes, respectively; p = 0.025). Median postoperative time to full enteral feeds was shorter by 4 days in the first group (7 vs. 11 days, respectively; p = 0.028). In accordance, the median duration of parenteral nutrition (PN) was less than half in the laparoscopic completed compared with the open group (5 vs. 11.5 days, respectively; p = 0.031). Postoperative opioids were required for only half the duration in the laparoscopically completed group compared with open (2 vs. 4 days, respectively; p = 0.026). Outcomes such as length of stay, the occurrence of strictures or adhesions requiring reintervention, or line sepsis were similar in both groups. Conclusion Patients undergoing laparoscopic CDO repair at our institution benefited from shorter time to full enteral feeds, and reduced the need for PN as well as postoperative pain medication.

Sign in / Sign up

Export Citation Format

Share Document