The late nonfunctioning duodenal atresia repair—a second look

Ein, Sigmund H.; Kim, Peter C.W.; Miller, H

doi:10.1053/jpsu.2000.6007

Cited by 27 publications

(21 citation statements)

References 4 publications

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“…Short bowel and dilated atonic proximal segment have been implicated as the causes of inadequate bowel functions by earlier researchers 1,7–10 . This is similar to the experiences reported by sophisticated treatment centers 6,13–15 …”

Section: Discussionsupporting

confidence: 82%

Management of intestinal atresia: Challenges and outcomes in a resource‐scarce region

Osifo

Okolo

2009

Surgical Practice

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Aim: Intestinal atresia is a common cause of intestinal obstruction in the newborn, associated with poor outcomes in many developing countries due to clinical sequelae of the lesion. Although outcomes have improved in many centers, the management requires facilities that are in short supply in developing countries. Here we report on five‐year outcomes, challenges, and experiences gained with the management of intestinal atresia in a resource‐scarce region and compare results with the preceding five years. Methods: A prospective study based on children diagnosed with intestinal atresia between July 2003 and June 2008 at the University of Benin Teaching Hospital, Benin City, Nigeria. Results were documented on a structured form and analyzed. The outcomes were compared between group A, comprising the preceding five years (July 1999–June 2003), and group B, comprising the present study group (July 2003–June 2008). Results: Forty‐three babies aged between 2 and 32 days (mean 11 ± 1.8 days), comprising 26 males and 17 females (ratio 1.5 : 1), were managed with intestinal atresia. Delayed presentation of these babies, which allowed fluid/electrolyte derangement, inanition, and established overwhelming resistant sepsis, as well as a lack of facilities, were major challenges resulting in poor outcomes (P < 0.0001). Aggressive resuscitation, resection of dilated proximal bowel segment allowing early commencement of oral feeds, enteroplasty, long use of broad spectrum antibiotics, improvised facilities to supply heat, and dedicated staff led to improved results. The number of survivors increased from 25% in group A to 75% in group B. Conclusion: This 75% survival rate could be increased further if there was provision of adequate facilities, especially total parenteral nutrition, and health awareness programs that result in early presentation.

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Section: Discussionsupporting

confidence: 82%

Management of intestinal atresia: Challenges and outcomes in a resource‐scarce region

Osifo

Okolo

2009

Surgical Practice

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“…[16][17][18] The post operative complications rate in previous reports ranged from 12 to 15% of patients with associated mortality rate of 6%. 5,[19][20][21] In this study the incidence of post operative complications were 26.3%, but we did not lose any patient.…”

Section: Discussionmentioning

confidence: 59%

Incomplete duodenal obstruction: a rare and late presentation

Eltayeb

Ibrahim

2015

Int Surg J

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“…9 However, cases of megaduodenum without profound anastomotic failure have also been reported, thus indicating ineffective peristalsis and a plausible disorder of functional origin to be the primary cause. 8 The type of primary repair in the current patient was a gastrojejunostomy, that functioned well for 65 years. However, this type of bypass procedure does not address the cause of the obstruction and is associated with inferior long-term outcomes in comparison to the current standards of surgical treatment for duodenal atresia.…”

Section: Discussionmentioning

confidence: 87%

“…Whether this procedure should be combined with the addition of a bypass procedure remains a matter of debate and the limited follow-up of cases with repaired duodenal atresia does not provide suffi cient evidence. 2,3,8 However, the risks of a primary closure of the duodenum were avoided in the current case, especially after such extensive manipulations, including a bypass procedure in the approach.…”

Section: Discussionmentioning

confidence: 91%

“…6,7 In addition, acquired megaduodenum is considered among the late complications displayed after primary repair of duodenal atresia and reports addressing the development of megaduodenum during adult life have described cases even 24 years after the initial surgical procedure. 3,8 The most recently published retrospective study of Escobar et al in 169 patients with long-term follow-up after duodenal atresia repair revealed that, megaduodenum is the second most common late-onset complication. 3 Furthermore, it was strongly associated with the need for reconstruction of the initially performed anastomosis, implicating a possible mechanical factor as the main cause of this entity.…”

Section: Discussionmentioning

confidence: 99%

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Duodenal web in an adult presenting with acute pancreatitis and acquired megaduodenum: Report of a case

et al. 2011

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Duodenal webs are a cause of intestinal atresia in infants and surgical repair is the established treatment of choice. However, the late-onset postoperative complications have not been adequately studied, especially in adults who have undergone surgical interventions as infants. This report describes the case of a 65-year-old female patient who presented with consecutive episodes of acute pancreatitis and a history of duodenal atresia repaired by a gastrojejunostomy in early infancy. Imaging studies revealed the presence of megaduodenum and suggested the possibility of impacted stones at the ampulla of Vater. An intact duodenal web at the level of papilla of Vater was revealed during surgery. Excision of the web, tapering of the duodenum and duodenojejunostomy was performed to relieve the obstructive cause of pancreatitis and to restore the intestinal continuity. At the 1-year follow-up, the patient is free of any symptoms, has no diet restrictions, and has increased her body weight as well.

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The late nonfunctioning duodenal atresia repair—a second look

Cited by 27 publications

References 4 publications

Management of intestinal atresia: Challenges and outcomes in a resource‐scarce region

Management of intestinal atresia: Challenges and outcomes in a resource‐scarce region

Incomplete duodenal obstruction: a rare and late presentation

Duodenal web in an adult presenting with acute pancreatitis and acquired megaduodenum: Report of a case

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