Abstract

AIM: This study reviewed the 6 years' experience of congenital duodenal obstruction management at the SSK Tepecik Teaching Hospital, Deparment of Pediatric Surgery and attempted to identify factors that might influence the outcome. MATERIAL and METHOD: A retrospective study was performed with analysis of 31 consecutive cases of congenital duodenal obstruction presenting between January 1994 and January 2000. RESULTS: Seventeen were males and 14 were females and seven were premature. Twenty-four had intrinsic defect (atresia, web, stenosis), 7 had extrinsic defect (annular pancreas, Ladd's bands). Presenting signs were bilious vomiting (96.8%), failure to pass stool (70.9%), abdominal distention (12.9%). Twentythree (74%)of the patients had associated anomalies. The operative repair included duodenoduodenostomy in 17 and/or web exeision, duodenojejunostomy in 7, duodenoplasty in 4, Ladd's procedure in 3 patients, or combination of the above. Two patients died before definitive surgery due to severe cardiac anomalies. Twentysix of operated 29 patient survived (89.6%). The causes of death vvere sepsis, pneumonia, and cardiac anomaly. CONCLUSION: Prematurity, associated congenital anomalies and nutritional compronüse are the prognostic factors in these patients. However, late referral of the patients may also complicate the duodenal obstruction of the newborn but, with agressive, timely operative management and postoperative nutritional support, survival may reach 90 percent.