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.

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.

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 the UK: a population-based study

2019 ◽  
Vol 105 (2) ◽  
pp. 178-183 ◽  
Author(s):  
George Stephen Bethell ◽  
Anna-May Long ◽  
Marian Knight ◽  
Nigel J Hall
Keyword(s):  
Duodenal Obstruction ◽  
Population Based ◽  
Small Sample ◽  
Associated Anomalies ◽  
Short Term ◽  
Population Based Study ◽  
Congenital Duodenal Obstruction ◽  
Operation Rate ◽  
The Uk ◽  
Postoperative Feeding

ObjectiveCongenital duodenal obstruction (CDO) comprising duodenal atresia or stenosis is a rare congenital anomaly requiring surgical correction in early life. Identification of variation in surgical and postoperative practice in previous studies has been limited by small sample sizes. This study aimed to prospectively estimate the incidence of CDO in the UK, and report current management strategies and short-term outcomes.DesignProspective population-based, observational study for 12 months from March 2016.SettingSpecialist neonatal surgical units in the UK.Main outcome measuresIncidence of CDO, associated anomalies and short-term outcomes.ResultsIn total, 110 cases were identified and data forms were returned for 103 infants giving an estimated incidence of 1.22 cases per 10 000 (95% CI 1.01 to 1.49) live births. Overall, 59% of cases were suspected antenatally and associated anomalies were seen in 69%. Operative repair was carried out mostly by duodenoduodenostomy (76%) followed by duodenojejunostomy (15%). Postoperative feeding practice varied with 42% having a trans-anastomotic tube placed and 88% receiving parenteral nutrition. Re-operation rate related to the initial procedure was 3% within 28 days. Two infants died within 28 days of operation from unrelated causes.ConclusionThis population-based study of CDO has shown that the majority of infants have associated anomalies. There is variation in postoperative feeding strategies which represent opportunities to explore the effects of these on outcome and potentially standardise approach. Short-term outcomes are generally good.

Marriage, monogamy and HIV: a profile of HIV-infected women in south India

2000 ◽  
Vol 11 (4) ◽  
pp. 250-253 ◽  
Author(s):  
S Newmann ◽  
P Sarin ◽  
N Kumarasamy ◽  
E Amalraj ◽  
M Rogers ◽  
...  
Keyword(s):  
Risk Factor ◽  
Hiv Risk ◽  
South India ◽  
Reproductive Age ◽  
Indian Women ◽  
Clinical Presentations ◽  
Vertical Transmission Of Hiv ◽  
History Of ◽  
The Mean ◽  
Heterosexual Sex

A retrospective study was conducted on 134 HIV-infected females evaluated at an HIV/AIDS centre in south India to characterize their socio-demographics, HIV risk factors and initial clinical presentations. The mean age was 29 years; 81% were housewives; 95% were currently or previously married; 89% reported heterosexual sex as their only HIV risk factor; and 88% reported a history of monogamy. The majority were of reproductive age, thus the potential for vertical transmission of HIV and devastating impacts on families is alarming. Nearly half of these women initially presented asymptomatically implying that partner recruitment can enable early HIV detection. Single partner heterosexual sex with their husband was the only HIV risk factor for the majority of women. HIV prevention and intervention strategies need to focus on married, monogamous Indian women whose self-perception of HIV risk may be low, but whose risk is inextricably linked to the behaviour of their husbands.

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.

scholarly journals Clinical Study of Congenital Duodenal Obstruction

1998 ◽  
Vol 15 (1) ◽  
pp. 67
Author(s):  
Young Soo Huh ◽  
Myeung Kook Lim ◽  
Sung Kyu Park
Keyword(s):  
Clinical Study ◽  
Duodenal Obstruction ◽  
Congenital Duodenal Obstruction

Congenital Duodenal Obstruction and Mongolism

BMJ ◽  
1952 ◽  
Vol 1 (4754) ◽  
pp. 384-385
Author(s):  
V. Smallpeice ◽  
M. Coxon
Keyword(s):  
Duodenal Obstruction ◽  
Congenital Duodenal Obstruction
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