Abstract
Background: Duodenal obstruction is a rare cause of congenital bowel obstruction. Prenatal ultrasound could be suggestive of duodenal atresia if polyhydramnios and the double bubble sign are visible. Prenatal diagnosis should prompt respective prenatal care, including surgery. The aim of this study was to investigate the rate and importance of prenatally diagnosed duodenal obstruction, comparing incomplete and complete duodenal obstruction. Methods: A retrospective, single-center study was performed using data from patients operated on for duodenal obstruction between 2004 and 2019. Prenatal ultrasound findings were obtained from maternal logbooks and directly from the investigating obstetricians. Postnatal data were obtained from electronic charts, including imaging, operative notes and follow-up. Results: A total of 33/64 parents of respective patients agreed to provide information on prenatal diagnostics. In total, 11/15 patients with complete duodenal obstruction and 0/18 patients with incomplete duodenal obstruction showed typical prenatal features. Prenatal diagnosis prompted immediate surgical treatment after birth. Conclusion: Prenatal diagnosis of congenital duodenal obstruction is only achievable in cases of complete congenital duodenal obstruction by sonographic detection of the pathognomonic double bubble sign. Patients with incomplete duodenal obstruction showed no sign of duodenal obstruction on prenatal scans and thus were diagnosed and treated later.
Highlights
Duodenal atresia is the most common type of congenital duodenal obstruction (CDO) and occurs in 1 per 5000–10,000 live births [1]
Congenital duodenal obstruction could be classified as complete congenital duodenal obstruction (CCDO) and incomplete congenital duodenal obstruction (ICDO)
After approval of the study by the local institutional review board committee “Ethik‐ kommission des Fachbereichs Medizin der Goethe Universitaet, Frankfurt”, we reviewed all prenatal ul‐ trasound (US) exams of children operated on for congenital duodenal obstruction (CDO) in the pediatric surgery department at our institution between 1 January 2004 and 31 May 2019 in a retrospective study
Summary
Duodenal atresia is the most common type of congenital duodenal obstruction (CDO) and occurs in 1 per 5000–10,000 live births [1]. Complete duodenal obstruction usually results from pure bowel atresia or annular pancreas, as opposed to incomplete atresia, which can be caused by an intraluminal web with a central opening. The detection of the double bubble sign by prenatal US is highly suspicious for CDO [2]. The aim of this study was to investigate the rate and importance of prenatally diagnosed duodenal ob‐ struction, comparing incomplete and complete duodenal obstruction. Conclusion: Prenatal diagnosis of congenital duodenal obstruction is only achievable in cases of complete con‐ genital duodenal obstruction by sonographic detection of the pathognomonic double bubble sign. Patients with incomplete duodenal obstruction showed no sign of duodenal obstruction on prenatal scans and were diagnosed and treated later
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