Congenital Duodenal Atresia Diagnosis, Treatment, and Influence on Further Development of Patients

Abstract

Background: Congenital duodenal atresia (CDA) is a common and surgically treated digestive tract anomaly that develops in the early stage of pregnancy. It often coexists with trisomy 21 and other inborn defects. Surgery is the only way of treatment. This study aimed to investigate the relationship of CDA with early diagnosis, course of pregnancy, coexisting congenital defects, and further development of children. Methods: The data were collected using the medical history and a self-designed survey which consisted of 22 questions about the perinatal interview, coexisting inborn defects, after birth symptoms, time and methods of diagnosis, as well as the treatment outcome. Results: The surveys were sent to 31 patients who were diagnosed and treated because of CDA in our clinic between 2004 and 2019. According to the collected data, 73.7% of the patients were diagnosed prenatally with the mean time of diagnosis at 28th weeks of gestation. Moreover, 37% of the patients were preborn, and almost half of the patients had low and very low body weight. More than 2/3 of children presented coexisting inborn abnormalities. Among after birth symptoms, the most common ones were abdominal distention and lack of meconium. The majority of children were operated within 24 hours after birth. Conclusions: Prenatal diagnosis of CDA results in an earlier time of primary operation. Newborns diagnosed antenatally present fewer symptoms after the operation, fewer reoperations, and a shorter time of oral feeding toleration. The coexistence of other congenital defects increases patients’ mortality. The important factors that deteriorate the postoperative course are prematurity and low body weight. In order to avoid long-term complications, it is of utmost importance to provide follow-up.

Keywords

• congenital
• duodenal atresia
• double bubble
• neonate
• surgery