Duodenal Obstruction in The First Month of Life

Abstract

Introduction: Duodenal obstruction in the 1st month of life is the most common etiology of bowelobstruction. We aim to analyzethe causes, clinical and diagnostic spectrum, management and surgicaloutcome of duodenal obstruction in the first month of life. The method that we used were 26 newborns ofduodenal obstruction reviewed by a cross- sectional study for 30 months (January 2017 - Jun 2019).All of thenewborns were investigated to the demographic details, causes, clinical presentation, associated anomalies,radiological findings, surgery performed and their outcome. Our results show that of 26 neonates (16 males,10 females). 17 newborns were presented within the first 3 days of life. The mean gestational age was 36.88weeks (10 preterms, 16 terms). The birth weight was normal in 16 newborns. Duodenal atresia was the mostfrequent cause in 9 (35%) neonates followed by the annular pancreas in 8(31%), malrotation in 6(23%),congenital duodenal web in 2 (8%)and congenital peritoneal band in 1 (4%). Greenish vomiting was themost common presentation in 38%. Double bubble gases by abdominal x- ray in 65%.Associated anomalieswere noted in 58%, cardiac defects being the most frequent 53%. Duodenoduodenostomy was performedin 73%. Feeding intolerance is the most frequent complication in 48%. 4 (15%) neonates died, mostlyin malrotation 50%. The commonest cause of death was midgut gangrene in 50%.We concluded that theDuodenal obstruction is a common problem in newborns. Greenish vomiting was the most common warningfinding. Associated anomalies were noted in more than half, cardiac defects being the most frequent. Earlydiagnosis and treatment is key to reduce post-surgical complications and improving outcome.