Fatal Course of a Male Newborn with Double Duodenal Atresia

Abstract

Multiple point duodenal atresia is an extremely rare condition with atretic segments in either two or three sites of the duodenum. We report a newborn male patient who presented to our institution with bilious vomiting, nonpassage of meconium, mild abdominal distension, and a palpable epigastric abdominal mass ∼1 × 1 cm. A faint double bubble was found on abdominal X-ray. On exploratory laparotomy, a duodenal cyst due to double duodenal atresia was found and a typical diamond-shaped duodeno-duodenostomy was created. A postoperative contrast study revealed passage of the contrast media into distal intestine. However, the patient died 2 weeks later due to uncontrolled sepsis and pneumonia. Despite the fact that multiple-point duodenal atresia is a rare condition, it should be considered as a differential diagnosis to avoid missed pathology.

Keywords: abdominal cyst; atresia; double; duodenum.

Fig. 1

PXR abdomen standing showing hugely dilated stomach and first part of the duodenum (double bubble sign).

Fig. 2

Intraoperative double duodenal atresia with duodenal cyst in between.

Fig. 3

Illustration showing the duodenal pathology.

Fig. 4

Postoperative contrast study with the dye passing into the small intestine.