Congenital Duodenal Obstruction: Evaluation of 68 Cases

Abstract

INTRODUCTION: Congenital duodenal obstruction, which is one of the most common causes of intestinal obstruction in neonates, gain importance in terms of associated anomalies. In this study, we aimed to review our experience with congenital duodenal obstruction cases operated in our clinic while evaluating the results of these patients. METHODS: All hospital records of neonates with congenital duodenal obstruction which had operated in our department between 2004 and 2017 were reviewed retrospectively. Patients were evaluated according to their demographic features, clinical presentations, associated anomalies, treatments and outcomes. RESULTS: During 13 years, 68 newborns (36 males, 32 females) with congenital duodenal obstruction were operated. The mean gestational age was 35.7±3.1weeks (28-44weeks), the mean birth weight was 2477±651.5 gram (1100–4100 gram) and 46 (67.7%) of them were premature. Associated abnormalities were detected in 37 neonates (54.4%); 16 of them (23.5%) had congenital cardiac malformations, and 13 of them (19.1%) had Down Syndrome. In neonates with associated abnormalities; the avarage period to start enteral feeding was 9.5±5.8 days (4-37days) and the mean hospitalization period was 25.6±26.2days (9-140days). These values were found 7.6±3.2 days (4-20days) and 17.5±13.7days (8-80days) respectively for the patients having no associated anomalies. Postoperative complications such as ileus, septicemia and nutritional intolerance were seen in 17 patients (25%); 3 of them (4.4%) need re-operation. While 63 patients (92.6%) were discharged on average 21.4±22 days (8-140 days); due to septicemia and severe congenital cardiac malformations 5 patients (7.4%) were died in 27.2±14.1 days (11-43days) postoperatively. The rate of septicemia was statistically significantly higher in patients with excitus than the ones who were discharged (p<0.001). DISCUSSION AND CONCLUSION: The presence of associated abnormalities in patients with congenital duodenal obstruction increases the risk of morbidity and mortality. Septicemia and severe congenital cardiac malformations adversely affect prognosis.