The late nonfunctioning duodenal atresia repair—a second look

• Published in: Journal of pediatric surgery Vol. 35; no. 5; pp. 690 - 691
• Main Authors: Ein, Sigmund H., Kim, Peter C.W., Miller, Hensley A.B.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01.05.2000; Elsevier
• Subjects: Adult; Anastomosis, Surgical - adverse effects; Anastomosis, Surgical - methods; Biological and medical sciences; Child, Preschool; Congenital Abnormalities - diagnosis; Congenital Abnormalities - surgery; Digestive System Surgical Procedures - adverse effects; Digestive System Surgical Procedures - methods; Duodenal atresia; Duodenal Diseases - etiology; Duodenal Diseases - surgery; Duodenum - abnormalities; Duodenum - surgery; Female; Follow-Up Studies; functional obstruction; Humans; Intestinal Obstruction - etiology; Intestinal Obstruction - surgery; Male; Medical sciences; Reoperation; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Treatment Outcome; Duodenal atresia; functional obstruction; Human; Duodenum; Treatment efficiency; Anastomosis; Congenital disease; Long term; Obstruction; Case study; Plication; Malformation; Surgery; Atresia; Digestive diseases; Intestinal disease
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1053/jpsu.2000.6007

Background/Purpose: In 1986, the authors reported on 3 newborns who had repair of their duodenal atresia, and between 6 and 18 months postoperatively an anastomotic obstruction developed in each suddenly. After prolonged medical and surgical treatments it became apparent that the duodenal atresia repair was functionally obstructed and plication of the dilated atonic proximal duodenum was curative. Since then, 2 more patients became so obstructed at 5 and 24 years postoperatively. The aim of this study was to report the very late occurrence of a functional obstruction of a newborn duodenal atresia repair. Methods: The 2 additional histories and surgical repairs were reviewed. Results: The 5-year old boy was cured immediately with plication only of his dilated proximal duodenum. The 24-year-old nurse had a very stormy 2-year course with several bypass operations, which did not relieve her abdominal pain and bile vomiting until they were taken down and her dilated proximal duodenum was plicated, after which she made a good recovery. Both remain well. Conclusion: An uncommon, very late, sudden, apparently anastomotic, postoperative, newborn, duodenal atresia repair obstruction caused by proximal, dilated, duodenal atony, and dysfunction can occur many years later and responds to duodenal plication alone. J Pediatr Surg 35:690-691. Copyright © 2000 by W.B. Saunders Company.