Long-term follow-up of congenital duodenal obstruction patients often falls on care providers with little experience of this condition. We performed a systematic review of the long-term outcomes of duodenal obstruction and provide a summary of sequelae care providers should anticipate.
METHODSIn 2022, after registering with PROSPERA, Medline (Ovid), EMBASE, PSYCHINFO, CNAHL and SCOPUS databases were searched using the title keyword 'intestinal atresia'. Abstracts were ltered for inclusion if they included the duodenum. Papers of ltered abstracts were included if they reported post-discharge outcomes. Methodological Index for Non-Randomized Studies was used to grade the papers.
RESULTSOf the 1068 abstracts were screened, 32 papers were reviewed. Eleven studies were included. Thirty additional papers were included after reviewing references, for a total of 41 papers. The average MINORS was 7/16.
CONCLUSIONSThere is good evidence that children with congenital duodenal obstruction do well in terms of survival, growth and general well-being. Associated cardiac, musculoskeletal and renal anomalies should be ruled-out. Care providers should be aware of anastomotic dysfunction, blind loop syndrome, bowel obstruction and re ux. Re ux may be asymptomatic. Laparoscopic repair does not change long-term outcomes, and associated Trisomy 21 worsens neurodevelopmental outcomes.
Identi cation of studiesWe performed a literature search of the databases Medline (Ovid), EMBASE, PSYCHINFO, CINAHL and SCOPUS using the keywords 'intestinal atresia', 'apple peel', 'jejunal atresia' and 'intestinal atresia'. Including 'ileal', 'duodenal' and 'colonic' did not change the results. We initially included studies for any site of intestinal atresia then divided the papers by the site of intestinal atresia: duodenal, jejuno-ileal and colonic. This review includes our summary of the duodenal literature. Jejuno-ileal and colonic reviews will be addressed in separate manuscripts. The original search was performed in June 2020 and a second search was performed in June 2022. No limitations were placed on publication date or language. Abstracts were uploaded to Rayyan, an online systematic review website [4].Within Rayyan, abstracts were independently ltered for possible inclusion by two authors (MI, SLM). The same two authors then agreed on which complete studies to review based on the ltered abstracts. Complete papers were independently assessed for possible inclusion by two authors (MI, SLM). If a con ict arose regarding inclusion or exclusion, papers were assessed by a third reviewer (AS). References of included papers were manually searched to identify papers that met the inclusion criteria but were not identi ed through the electronic database searches.