
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions β written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Duodenal atresia surgery
Introduction
Overview
Overview
Surgery is the mainstay of treatment for duodenal atresia. A nasogastric or orogastric tube should be inserted to decompress the abdomen. A laparotomy or laparoscopy can be performed to correct duodenal atresia. Surgical procedures for the correction of duodenal atresia include duodenoduodenostomy and duodenojejunostomy.
Indications
Indications
Surgery is the first-line treatment option for patients with duodenal atresia. If the case is confirmed by: [1]
- Ultrasound: shows duodenal obstruction
- Abdominal x-ray: shows air fluid levels
Surgery
Surgery
Surgery is the mainstay of treatment for duodenal atresia.[1][2][3]
- Laparotomy or laparoscopy can be performed.
- A nasogastric or orogastric tube should be inserted to decompress the abdomen.
Surgical procedures include:
- Side-to-side duodenoduodenostomy
- Bypass procedure
- Diamond-shaped anastomosis is constructed between the proximal transverse to the distal longitudinal anastomosis
- End-to-side duodenoduodenostomy
- Bypass procedure
- Diamond-shaped anastomosis is constructed between the proximal transverse to the distal longitudinal anastomosis
- Duodenojejunostomy
Post Operative Care
- Orogastric tube is left in place for drainage
- Oral feedings not given until
- Give total parenteral nutrition (TPN)
Preparation for surgery
- Orogastric decompression of the stomach
- Fluid resuscitation
- Broad-spectrum antibiotics
- 1 mg vitamin K
Post Surgical Complications
The post surgical complications of duodenal atresia are as follows:[4][5][6]
- Post surgical complications include:
- Adhesions
- Blind loop syndrome
- Duodenal dysmotility
- Megaduodenum
- Duodenogastric reflux and gastritis
- Peptic ulcer disease
- Gastroesophageal reflux
- Cholelithiasis
- Cholecystitis
Contraindications
Contraindications
There are no contraindications to surgical repair of duodenal atresia.
References
References
- β 1.0 1.1 Freeman, SB; Torfs, CP; Romitti, PA; Royle, MH; Druschel, C; Hobbs, CA; Sherman, SL (2009). “Congenital gastrointestinal defects in Down syndrome: a report from the Atlanta and National Down Syndrome Projects”. Clinical Genetics. 75 (2): 180β184. doi:10.1111/j.1399-0004.2008.01110.x. ISSNΒ 0009-9163.
- β Kay, Saundra; Yoder, Suzanne; Rothenberg, Steve (2009). “Laparoscopic duodenoduodenostomy in the neonate”. Journal of Pediatric Surgery. 44 (5): 906β908. doi:10.1016/j.jpedsurg.2009.01.025. ISSNΒ 0022-3468.
- β Morris, Grant; Kennedy, Alfred; Cochran, William (2016). “Small Bowel Congenital Anomalies: a Review and Update”. Current Gastroenterology Reports. 18 (4). doi:10.1007/s11894-016-0490-4. ISSNΒ 1522-8037.
- β Spigland N, Yazbeck S (1990). “Complications associated with surgical treatment of congenital intrinsic duodenal obstruction”. J Pediatr Surg. 25 (11): 1127β30. PMIDΒ 2273425.
- β Kokkonen ML, Kalima T, JÀÀskelΓ€inen J, Louhimo I (1988). “Duodenal atresia: late follow-up”. J Pediatr Surg. 23 (3): 216β20. PMIDΒ 3357136.
- β Bishay, M.; Lakshminarayanan, B.; Arnaud, A.; Garriboli, M.; Cross, K. M.; Curry, J. I.; Drake, D.; Kiely, E. M.; De Coppi, P.; Pierro, A.; Eaton, S. (2012). “The role of parenteral nutrition following surgery for duodenal atresia or stenosis”. Pediatric Surgery International. 29 (2): 191β195. doi:10.1007/s00383-012-3200-9. ISSNΒ 0179-0358.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]
