Translate this page into:
A prospective study of antenatal and clinical suspected duodenal obstruction with their etiological diversities.
*Corresponding Author: Dr. Mahesh Vaghela Email: dr.maheshvaghela7@gmail.com
Abstract
Introduction:
Congenital duodenum obstruction is usually diagnosed in the neonatal period, but partial obstruction may present at a later age. Aprospective study of 84 congenital duodenal obstruction cases was conducted at our institute from July 2012 to October 2016.
Materials and method:
The cases were selected by antenatal diagnosis and postnatal clinical manifestation. We included antenatal diagnosis, age at presentation, gender distribution, clinical manifestation, investigation, diagnosis, associated anomalies, intra-operative finding, surgical procedure, complications and outcomes as study parameters.
Result:
Congenital duodenal obstruction was diagnosed in 60.71 % (n=51) patients in neonatal life, 21.4 % (n=18) patients below 1 year and 17.89% (n=15) patients after 1 year. Eighteen cases were diagnosed on antenatal ultrasonography. Forty patients (48.5%) were diagnosed on plain X-ray. Ultrasonography and Contrast study were required in 44 cases (51.5%). We found complete obstruction in 40 (48.5%) cases (duodenal atresia- 34, annular pancreas-6) and partial obstruction in 44 (51.5 %) cases (malrotation-32, duodenal web-12).Kimura’s Duodeno-duodenostomy was performed in 40 patients (34-duodenal atresia, 6-annular pancreas). Duodenotomy with web excision and duodenoplasty was done for 12 patients. Ladd’s procedure was performed for 32 patients. Twelve patients (14.28%) died postoperatively.
Conclusion:
Congenital duodenal obstruction is a common surgical entity in neonates with diversity of embryonic developmental etiologies. Duodenal atresia is most common cause. Antenatal ultrasonography is important in early diagnosis. The treatment is always surgical.
