Duodenal atresia

Question 1

Definition

Answer 1

-Congenital discontinuity of the duodenum usually in the region of the ampulla of Vater that leads to bowel obstruction

Question 2

Clinical features

Answer 2

o Antenatal history of polyhydramnios , dilated stomach & proximal Duodenum
o Vomiting; clear or bile stained Bilious vomiting within hours of birth (green in colour)
o Distended stomach
o Delayed passage of and small amounts of meconium

Question 3

Investigations

Answer 3

o Abdominal x ray :double bubble sign of distended stomach and duodenum can be seen in antenata us as double fluid collection
o Blood : electrolytes, glucose and blood gases

Question 4

Treatment

Answer 4

y Stop enteral feeding, start IVF, and insert nasogastric tube on free drainage
y Correct electrolyte and acid base disturbances
y Transfer to a surgical center when stable for repair

Question 5

Duodenal abstraction causes

Answer 5

• duodenal atresia
• annular pancreas
• anterior portal vein
• mass

Question 6

Associated anomalies:

Answer 6

40% have trisomy 21 (Down`s syndrome), cardiac, genitourinary,

anorectal & esophagealatresia.