Duodenal Atresia

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What is duodenal atresia?

Duodenal atresia is a condition in which the duodenum (the first part of the small intestine) develops improperly. As a result, a blockage occurs, and the contents of the stomach can not pass beyond the obstruction.

What are the causes and incidence?

The cause of duodenal atresia is unknown. During the developmental stage of the duodenum, the embryo’s duodenum normally changes from solid to tube-like (recanalization), but in this condition, recanalization fails. Duodenal atresia is present in more than 1 in 10,000 live births. Approximately one-third of infants with duodenal atresia may have Trisomy 21 (Down’s syndrome), as well as other congenital abnormalities.

What are the symptoms?

The abdomen may appear to be normal. Early vomiting ensues and is often green due to the presence of bile. Vomiting often continues, even when the infant has not been fed.

What is the treatment?

A tube is placed to decompress the stomach and an abdominal X-ray is obtained. Dehydration and electrolyte abnormalities are corrected by intravenous fluids. An evaluation for other congenital anomalies should be performed (ultrasound).

Surgery to correct the duodenal blockage is necessary, but may be performed in one or two days after birth. An operation, duodenoduodenostomy, restores intestinal continuity and alleviates the blockage.

What is the expected outcome?

Recovery from surgery and recovery of intestinal function requires 5-10 days. During this period your baby will be fed by vein. If you plan to breastfeed we will encourage you to pump your milk, and the milk will be stored for use until the baby can breastfeed. Recovery from the duodenal atresia is expected after treatment. Untreated, the condition is fatal.

 

What are the complications?

  • Associated congenital anomalies
  • After surgery, there may be late complications such as duodenal dysfunction (megaduodenum or abnormal motility) or gastroesophageal reflux. A feeding tube (gastrostomy) is rarely

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