Abstract
Introduction: There is no consensus in the available literature whether the coexistence of Down’s syndrome has adverse effect on the outcomes of neonates born with congenital duodenal atresia.Materials and Methods: A total of 29 neonates with congenital duodenal atresia were retrospectively studied for demographic details, sepsis parameters at admission, management, morbidity, and mortality. The neonates who were prematureResults: The sepsis parameters such as total leukocyte counts, erythrocyte sedimentation rate, serum procalcitonin levels, and serum C‑reactive protein levels were significantly increased, and the platelets were significantly decreased at admission in Group B subjects, as compared to Group A subjects. There were no complications noted in Group A, while Group B had significant morbidity. The neonates with congenital duodenal atresia with Down’s syndrome had 3.27 times more relative risk of mortality than those without Down’s syndrome. Down’s syndrome appears to be an independent risk factor for mortality in isolated congenital duodenal atresia with attributable risk of 37.8%.Conclusion: The presence of Down’s syndrome is a significant independent adverse risk factor of outcomes in isolated congenital duodenal atresia.
Highlights
There is no consensus in the available literature whether the coexistence of Down’s syndrome has adverse effect on the outcomes of neonates born with congenital duodenal atresia
Complete failure of recanalization results in duodenal atresia which presents in the immediate neonatal period, whereas incomplete recanalization results in duodenal stenosis, or duodenal web that can have a variable and delayed presentation [2]
The most important medical causes of post‐operative mortality are due to complex cardiac anomalies, prematurity, sepsis, and pneu‐ monia and the most common surgical complications seen are anastomotic leak and gastroduodenal pare‐ sis [3]
Summary
There is no consensus in the available literature whether the coexistence of Down’s syndrome has adverse effect on the outcomes of neonates born with congenital duodenal atresia. The neonates with congenital duodenal atresia with Down’s syndrome had 3.27 times more relative risk of mortality than those without Down’s syndrome. Down’s syndrome appears to be an independent risk factor for mortality in isolated congenital duodenal atresia with attributable risk of 37.8%. Conclusion: The presence of Down’s syndrome is a significant independent adverse risk factor of outcomes in isolated congenital duodenal atresia. Associated congenital anomalies have been identified as an independent risk factor for mortal‐ ity in duodenal atresia, with prematurity and low birth weight increasing the mortality risk [4,5]. Lit‐ erature suggests that Down’s syndrome per se does not affect the survival of duodenal atresia postoper‐ atively; the association of multiple anoma‐ lies, especially major cardiac anomalies, can affect the outcome [3,6]
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