Duodenal atresia with apple peel associated with congenital diaphragmatic hernia: an exceptional case and a literature review

• Published in: Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Vol. 35; no. 1; p. 31
• Main Authors: Molino Gahete, J A, López Fernández, S, Oliver, B, Boix, H, Rocha, O, López, M, Guillén, G
• Format: Journal Article
• Language: English
• Published: Spain 01.01.2022
• Subjects: Duodenal Obstruction - etiology; Duodenal Obstruction - surgery; Female; Hernias, Diaphragmatic, Congenital - surgery; Humans; Intestinal Atresia - surgery; Malus; Congenital diaphragmatic hernia; Intestinal atresia; Congenital malformation; Duodenal atresia; Apple peel
• ISSN: 2445-2807

Duodenal atresia associated with apple peel is extremely rare. Duodenal atresia occurs as a result of absence of recanalization at an early stage, whereas intestinal atresia is seemingly due to vascular causes at later stages. The presence of abnormalities associated with diaphragmatic hernia is frequent, but association with duodenal atresia has been little explored. This is the case of a female neonate born at gestational week 31, with duodenal atresia and apple peel, associated with left diaphragmatic hernia and major heart disease. An abdominal muscle flap was performed for diaphragmatic defect closure purposes, and duodenojejunal anastomosis was carried out following resection of part of the non-viable apple peel. To our knowledge, this is the first case described with this rare association. The combination of duodenal atresia and apple peel had been previously described 11 times. However, the association of both with congenital diaphragmatic hernia had not been reported yet.