A prospective study of antenatal and clinical suspected duodenal obstruction with their etiological diversities.
Journal Title: BJKines-National Journal of Basic & Applied Science - Year 2019, Vol 11, Issue 1
Abstract
Introduction: Congenital duodenum obstruction is usually diagnosed in the neonatal period, but partial obstruction may present at a later age. A prospective 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.
Authors and Affiliations
Dr. Rakesh Joshi, Dr. Mahesh Vaghela, Dr. Aniz Ratani, Dr. Jaishri Ramji
Keywords
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