Duodenal Obstruction in The First Month of Life

Abstract

Introduction: Duodenal obstruction in the 1st month of life is the most common etiology of bowel
obstruction. We aim to analyzethe causes, clinical and diagnostic spectrum, management and surgical
outcome of duodenal obstruction in the first month of life. The method that we used were 26 newborns of
duodenal obstruction reviewed by a cross- sectional study for 30 months (January 2017 - Jun 2019).All of the
newborns 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 36.88
weeks (10 preterms, 16 terms). The birth weight was normal in 16 newborns. Duodenal atresia was the most
frequent 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 the
most common presentation in 38%. Double bubble gases by abdominal x- ray in 65%.Associated anomalies
were noted in 58%, cardiac defects being the most frequent 53%. Duodenoduodenostomy was performed
in 73%. Feeding intolerance is the most frequent complication in 48%. 4 (15%) neonates died, mostly
in malrotation 50%. The commonest cause of death was midgut gangrene in 50%.We concluded that the
Duodenal obstruction is a common problem in newborns. Greenish vomiting was the most common warning
finding. Associated anomalies were noted in more than half, cardiac defects being the most frequent. Early
diagnosis and treatment is key to reduce post-surgical complications and improving outcome.