ABSTRACT
Background/ Purpose: Congenital duodenal obstruction is a frequent cause of intestinal obstruction in the newborn. This study aimed to analyze various factors affecting the outcome of these cases at our institution
Materials and Methods: Seventy one cases of congenital duodenal obstruction were included in this retrospective review. Each case was studied as regard to: age at presentation, gestaional age, clinical data, other associated congenital anomalies, cause of obstruction, management, and outcome. Patients with abdominal wall defects [omphalocoele, gastroschisis] and diaphragmatic hernias were excluded from the study
Results: The causes of duodenal obstruction were: duodenal atresia [n= 37], duodenal diaphragm [n= 12], malrotation [n= 14], and annular pancreas [n= 8]. Age ranged from 2 days to 24 months. Bilious vomiting was the main presenting symptom. Plain radiography was the most valuable diagnostic tool in all cases except malrotation and partial obstruction. Gastrointestinal [GIT] contrast study was very valuable in that later group. Overall mortality was 15 cases [21.1 %]. The causes of deaths were: prolonged gastric stasis and neonatal sepsis[n= 7], other associated cardiac anomalies [n=5], and extensive bowel gangrene due to neglected volvulus neonatorum[n= 3]
Conclusion: This study showed that [1] the diagnosis of congenital duodenal obstruction is still delayed in many patients referred to our institutions.[2] early postoperative survival is still far from ideal ; [3] the mortality is related to delayed presentation, associated cardiac defects, and prolonged gastric stasis; and [4] late complications are more common than previously expected