[Megaduodenum in chronic intestinal pseudo-obstruction: management by duodenectomy-duodenoplasty]

Abstract

Background: Surgical management of primitive chronic intestinal pseudo-obstruction involving the duodenum (megaduodenum) is an uncommon but still difficult problem.

Patients and methods: Six patients who experienced severe symptoms were managed by an original surgical procedure including partial duodenal resection and reconstruction of a duodenal tract using a large duodenal anastomosis (duodenectomy-duodenoplasty).

Results: There was no postoperative complication. All preoperative symptoms completely regressed in all but one patient who had previously undergone a vagotomy and experienced transient early post-operative gastric stasis. With a median follow-up of 6 years (range 4-9), all patients had good functional results without any evidence of other motility disorders. The mean weight gain was 10 kg (range 7-15).

Conclusions: Duodenectomy-duodenoplasty is a safe procedure resulting in efficient symptom relief in patients suffering from megaduodenum.