Duodenal atresia

Abstract

Duodenal atresia is the most common type of intestinal obstruction identified in the newborn period. The diagnosis is often suspected prenatally, and pediatric surgeons are increasingly asked to consult with the parents of an unborn child with duodenal atresia. Associated anomalies include trisomy 21, congenital heart defects, and malrotation of the intestines. The classic imaging finding is that of a dilated stomach and proximal duodenum, a “double bubble." The standard repair is a diamond-shaped duodenoduodenostomy usually performed in the first few days of life. The laparoscopic approach is considered standard in some centers. In duodenal stenosis, the obstruction is incomplete, and there is usually a web across the lumen of the duodenum with a small opening in the center. The web can be resected or bypassed with a duodenoduodenostomy. If the pediatric surgeon pays careful attention to detail at the time of the repair, the chances of a successful outcome are very high and the long-term outlook is very good.