Duodenal atresia surgery

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.

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 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

• Orogastric tube is left in place for drainage
• Oral feedings not given until
  • Bowel sounds are heard
  • Stool is passed
  • Gastric drainage is limited (<1 mL/kg/hr of clear or pale-green fluid).
• Give total parenteral nutrition (TPN)

• Orogastric decompression of the stomach
• Fluid resuscitation
• Broad-spectrum antibiotics
• 1 mg vitamin K

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

There are no contraindications to surgical repair of duodenal atresia.

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