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Nam and Lim: Duodenal Obstruction due to Duodenal Web in Three-year-old Girl: A Case Report
Case Report

Journal of the Korean Association of Pediatric Surgeons 2014; 20(2): 65-68.

Published online: 30 December 2014

DOI: https://doi.org/10.13029/jkaps.2014.20.2.65

Duodenal Obstruction due to Duodenal Web in Three-year-old Girl: A Case Report

So Hyun Nam1, Yun-Jung Lim2

1Department of Surgery, Inje University Haeundae Paik Hospital, Busan, Korea.

2Department of Radiology, Inje University Haeundae Paik Hospital, Busan, Korea.

Correspondence: So Hyun Nam, Department of Surgery, Inje University Haeundae Paik Hospital, 875, Haeun-daero, Haeundae-gu, Busan 612-896, Korea. Tel: +82-51-797-0260, Fax: +82-51-797-0276, namsh@paik.ac.kr

Received 19 September 2014       Revised 10 October 2014       Accepted 13 October 2014

Copyright © 2014 by the Korean Association of Pediatric Surgeons

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Congenital duodenal obstruction is a one of the emergent surgical conditions in neonates. Almost of them were diagnosed with double-bubble sign in prenatal ultrasonography. However, partial obstruction caused from duodenal web could be overlooked. We reported a duodenal web in early childhood. A three-year-old girl visited at our pediatric clinic for constipation. She had been showed non-bilious vomiting after weaning meal since 6 months old of her age, but her weight was relevant for 50-75 percentile of growth curve. Barium enema was initially checked, but any abnormal finding was not found. We noticed the severely distended stomach and 1st portion of duodenum. Upper gastrointestinal series revealed partial obstruction in 2nd portion of duodenum. After laparotomy, we found the transitional zone of duodenum and identified a duodenal web via duodenotomy. We performed duodeno-duodenostomy without any injury of ampulla of Vater. She was recovered uneventfully. During 6 months after operation, she does well without any gastrointestinal symptoms or signs, such as vomiting or constipation.

Keywords: Duodenal obstruction, Congenital, Child

Figures and Tables

Fig. 1
Simple X-ray shows severe dilated stomach and duodednum 1st portion.
jkaps-20-65-g001
Fig. 2
Upper gastrointestinal series showed partial obstruction in 2nd portion of duodenum with abrupt narrowing caused by web (line).
jkaps-20-65-g002
Fig. 3
(A) We found transition zone grossly. (B) We did enterotomy at the 1st portion. Duodenal web was visible and 8 Fr foley catheter was inserted via web opening. (C) We did duodenoduodenostomy.
jkaps-20-65-g003

Notes

No potential conflict of interest relevant to this article was reported.

References

1. Kimura K, Loening-Baucke V. Bilious vomiting in the newborn: rapid diagnosis of intestinal obstruction. Am Fam Physician. 2000; 61:2791–2798.
2. Dalla Vecchia LK, Grosfeld JL, West KW, Rescorla FJ, Scherer LR, Engum SA. Intestinal atresia and stenosis: a 25-year experience with 277 cases. Arch Surg. 1998; 133:490–496. discussion 496-7.
3. Murshed R, Nicholls G, Spitz L. Intrinsic duodenal obstruction: trends in management and outcome over 45 years (1951-1995) with relevance to prenatal counselling. Br J Obstet Gynaecol. 1999; 106:1197–1199.
4. Chhabra R, Suresh BR, Weinberg G, Marion R, Brion LP. Duodenal atresia presenting as hematemesis in a premature infant with Down syndrome. Case report and review of the literature. J Perinatol. 1992; 12:25–27.
5. Grosfeld JL, Rescorla FJ. Duodenal atresia and stenosis: reassessment of treatment and outcome based on antenatal diagnosis, pathologic variance, and long-term follow-up. World J Surg. 1993; 17:301–309.
6. Escobar MA, Ladd AP, Grosfeld JL, West KW, Rescorla FJ, Scherer LR 3rd, et al. Duodenal atresia and stenosis: long-term follow-up over 30 years. J Pediatr Surg. 2004; 39:867–871.
7. Maclennan AC. Investigation in vomiting children. Semin Pediatr Surg. 2003; 12:220–228.
8. Tandler J. Zur Entwicklungs-geschichte des menschlichen: duodenums in fruhen embryonalstadium. Mohphol Jahrb. 1900; 29:187–216.
9. Peetsold MG, Ekkelkamp S, Heij HA. Late presentation of a duodenal web in a patient with situs inversus and apple peel jejunal atresia. Pediatr Surg Int. 2004; 20:301–303.
10. Gray SW, Skandalakis JE. Embryology for surgeons: the embryological basis for the treatment of congenital defects. Philadelphia: WB Saunders;1972. p. 147–148.
11. Kimura K, Mukohara N, Nishijima E, Muraji T, Tsugawa C, Matsumoto Y. Diamond-shaped anastomosis for duodenal atresia: an experience with 44 patients over 15 years. J Pediatr Surg. 1990; 25:977–979.
12. Nixon HH. Duodenal atresia. Br J Hosp Med. 1989; 41:134. 138. 140.
13. Mooney D, Lewis JE, Connors RH, Weber TR. Newborn duodenal atresia: an improving outlook. Am J Surg. 1987; 153:347–349.
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