The importance of antenatal diagnosis of congenital duodenal obstruction

Abstract

Introduction: The aim of this study was to compare the outcome of operated newborns that had an antenatal diagnosis of congenital duodenal obstruction (CDO) with those who had a late diagnosis in the postpartum period.

Materials and methods: The newborns that were operated with the diagnosis of CDO in our department were retrospectively recorded. The patients were grouped according to the time of diagnosis; the ones who had an antenatal diagnosis were assigned to group 1, while the ones that had a diagnosis in the postpartum period were assigned to group 2. The groups were compared in terms of their pregnancy weeks at the time of birth, birth weight, additional congenital anomalies, the type of obstruction, the procedures that are applied, the day of operation, the time for oral feeding tolerance, the duration of hospital stay, and pre- and post-operative complications.

Results: Fifteen patients with a diagnosis of CDO were operated on in our department between 2009 and 2014. Eight patients were male and seven patients were female. There were nine patients in group 1 and six patients in group 2. The diagnosis was confirmed in group 1 on the first day of the postpartum period. In the subanalysis, five patients had type 1 CDO and four had type 3 CDO in group 1, while five patients had type 1 CDO and one had type 3 CDO in group 2. There was not any complication in group 1 in the pre-operative period, but two patients had aspiration pneumonia and one had dehydration in group 2 pre-operatively. The mean operation day in the postpartum period was 2.34 (±0.5) days in group 1 and 7.17 (±2.04) in group 2. The time for the patient to tolerate oral feeding in the post-operative period was 11.33 (±1.80) in group 1 and 14.83 (±2.48) in group 2. The duration of hospital stay in group 1 was 20.67 (±9.81) days and 24.66 (±4.50) days in group 2. In the post-operative period, chylous ascites occured in a patient in group 1 and the post-operative period was complicated with ileus in one patient in group 2. No mortalities happened in both groups.

Conclusion: The prenatal diagnosis of CDO affects the pre-operative complication rate, the time for the operation in the postpartum period, the duration to start post-operative oral feeding, and the duration of hospital stay, but does not affect the mortality or the morbidity.

Keywords: Congenital duodenal obstruction; Double bubble; Prenatal diagnosis.