Single balloon dilation of symptomatic duodenal web: Long-term success

Abstract

Duodenal webs in neonates and infants have been traditionally managed with open or laparoscopic surgery. Surgical management has been associated with high morbidity and mortality and prolonged length of stay. Other treatments include endoscopic resection of the web with cautery or laser energy. This modality carries a high risk of perforation. Endoscopic balloon dilatation has been recently reported with good clinical outcome. Most of the patients reported in the literature required serial balloon dilatations to achieve resolution of the symptoms. We report a 10-month-old infant with duodenal obstruction secondary to a congenital duodenal web. He was successfully managed with a single high-pressure balloon dilatation using an interventional radiology technique. He tolerated liquid diet on day 2 post procedure and was discharged home on day 3. He has remained asymptomatic after 4 years of follow-up.

Keywords

• Duodenal web
• Balloon dilatation
• Congenital duodenal obstruction
• Congenital gastrointestinal obstruction