Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2019 Jul 28;25(28):3787-3797.
doi: 10.3748/wjg.v25.i28.3787.

Comparison of outcomes between complete and incomplete congenital duodenal obstruction

Stefan Gfroerer  1 , Till-Martin Theilen  2 , Henning C Fiegel  2 , Anoosh Esmaeili  3 , Udo Rolle  2
Affiliations
Comparative Study

Comparison of outcomes between complete and incomplete congenital duodenal obstruction

Stefan Gfroerer et al. World J Gastroenterol. .

Abstract

Background: Congenital duodenal obstruction (CDO) can be complete (CCDO) or incomplete (ICDO). To date there is no outcome analysis available that compares both subtypes.

Aim: To quantify and compare the association between CCDO and ICDO with outcome parameters.

Methods: We retrospectively reviewed all patients who underwent operative repair of CCDO or ICDO in our tertiary care institution between January 2004 and January 2017. The demographics, clinical presentation, preoperative diagnostics and postoperative outcomes of 50 patients were compared between CCDO (n = 27; atresia type 1-3, annular pancreas) and ICDO (n = 23; annular pancreas, web, Ladd´s bands).

Results: In total, 50 patients who underwent CDO repair were enrolled and followed for a median of 5.2 and 3.9 years (CCDO and ICDO, resp.). CCDO was associated with a significantly higher prenatal ultrasonographic detection rate (88% versus 4%; CCDO vs ICDO, P < 0.01), lower gestational age at birth, lower age and weight at operation, higher rate of associated congenital heart disease (CHD), more extensive preoperative radiologic diagnostics, higher morbidity according to Clavien-Dindo classification and comprehensive complication index (all P ≤ 0.01). The subgroup analysis of patients without CHD and prematurity showed a longer time from operation to the initiation of enteral feeds in the CCDO group (P < 0.01).

Conclusion: CCDO and ICDO differ with regard to prenatal detection rate, gestational age, age and weight at operation, rate of associated CHD, preoperative diagnostics and morbidity. The degree of CDO in mature patients without CHD influences the postoperative initiation of enteral feeding.

Keywords: Adverse events; Clinical presentation; Congenital duodenal obstruction; Duodenal atresia; Duodenal stenosis; Outcome; Prenatal ultrasonographic detection rate; Preoperative diagnostics.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Radiographic images of complete and incomplete congenital duodenal obstruction. A: Complete congenital duodenal obstruction, the plain abdominal X-ray of a newborn infant with duodenal atresia type 1 displays a characteristic double bubble sign; B: Incomplete congenital duodenal obstruction, contrast study of a 2 month old infant with duodenal web (arrows).
Figure 2
Figure 2
Absolute frequencies of operative repairs and corresponding age at operation for 50 patients with complete or incomplete congenital duodenal obstruction.
See this image and copyright information in PMC

References

    1. Dalla Vecchia LK, Grosfeld JL, West KW, Rescorla FJ, Scherer LR, Engum SA. Intestinal atresia and stenosis: A 25-year experience with 277 cases. Arch Surg. 1998;133:490–6; discussion 496-7. - PubMed
    1. Bales C, Liacouras CA. Philadelphia: Elsevier Inc.,; 2016. Intestinal atresia, stenosis and malrotation. 20th ed. Kliegman RM, Stanton BF, St Geme JW, Schor NF, editor. Nelson Textbook of pediatrics; pp. 1800–1804.
    1. Lawrence MJ, Ford WD, Furness ME, Hayward T, Wilson T. Congenital duodenal obstruction: Early antenatal ultrasound diagnosis. Pediatr Surg Int. 2000;16:342–345. - PubMed
    1. Grosfeld JL, Rescorla FJ. Duodenal atresia and stenosis: Reassessment of treatment and outcome based on antenatal diagnosis, pathologic variance, and long-term follow-up. World J Surg. 1993;17:301–309. - PubMed
    1. Bairdain S, Yu DC, Lien C, Khan FA, Pathak B, Grabowski MJ, Zurakowski D, Linden BC. A modern cohort of duodenal obstruction patients: Predictors of delayed transition to full enteral nutrition. J Nutr Metab. 2014;2014:850820. - PMC - PubMed

Publication types

MeSH terms