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Congenital duodenal obstruction in children: a decade's experience.

INTRODUCTION
Congenital duodenal obstruction (CDO) is one of the most common anomalies in newborns and infants. In 38-55% of patients, intrinsic duodenal obstruction is associated with another significant congenital anomaly. We report on a retrospective study of all children born with CDO presented to our institution over a 10-year period.


PATIENTS AND METHODS
A retrospective analysis was carried out of the records of all children admitted to our center from January 1996 to December 2005 with the diagnosis of congenital duodenal obstruction. Seventy-seven patients were enrolled in the study. Age ranged from 1 day to 3 months; there were 44 males and 33 females. Weight ranged from 800 g to 4.5 kg. Five babies (6.49%) were born prematurely between 31 and 34 weeks' gestation. For the purposes of comparison, duodenal obstruction was divided into 3 groups according to the intraoperative findings. The follow-up period ranged from 6 months to 5 years. The collected data were tabulated, compared, and statistically analyzed.


RESULTS
Patients were divided into 3 groups: group 1 (duodenal atresia) consisted of 32 patients, group 2 (annular pancreas) consisted of 30 patients and group 3 (duodenal web) consisted of 15 patients. Twenty-five patients (32.4%) were diagnosed with pure duodenal obstruction, while 52 cases (67.5%) had other associated anomalies. Cardiac anomalies, Down syndrome, GIT anomalies and renal anomalies were the most commonly occurring associated anomalies.


CONCLUSION
Congenital duodenal obstruction repair can have a very good outcome, as our study shows. Associated congenital cardiac, GIT, and respiratory anomalies were the main cause of postoperative morbidity. Down syndrome did not influence morbidity. Mortality was unrelated to duodenal obstruction.