J Korean Assoc Pediatr Surg.  2014 Dec;20(2):65-68. 10.13029/jkaps.2014.20.2.65.

Duodenal Obstruction due to Duodenal Web in Three-year-old Girl: A Case Report

• Nam SH
• Lim YJ

• KMID: 1961490
• DOI: http://doi.org/10.13029/jkaps.2014.20.2.65

Abstract

Congenital duodenal obstruction is a one of the emergent surgical conditions in neonates. Almost of them were diagnosed with double-bubble sign in prenatal ultrasonography. However, partial obstruction caused from duodenal web could be overlooked. We reported a duodenal web in early childhood. A three-year-old girl visited at our pediatric clinic for constipation. She had been showed non-bilious vomiting after weaning meal since 6 months old of her age, but her weight was relevant for 50-75 percentile of growth curve. Barium enema was initially checked, but any abnormal finding was not found. We noticed the severely distended stomach and 1st portion of duodenum. Upper gastrointestinal series revealed partial obstruction in 2nd portion of duodenum. After laparotomy, we found the transitional zone of duodenum and identified a duodenal web via duodenotomy. We performed duodeno-duodenostomy without any injury of ampulla of Vater. She was recovered uneventfully. During 6 months after operation, she does well without any gastrointestinal symptoms or signs, such as vomiting or constipation.

Keyword

Duodenal obstruction; Congenital; Child

MeSH Terms

Ampulla of Vater
Barium
Child
Constipation
Duodenal Obstruction*
Duodenum
Enema
Female
Humans
Infant, Newborn
Laparotomy
Meals
Stomach
Ultrasonography, Prenatal
Vomiting
Weaning
Barium

Figure

• 

  Fig. 1 Simple X-ray shows severe dilated stomach and duodednum 1st portion.

• 

  Fig. 2 Upper gastrointestinal series showed partial obstruction in 2nd portion of duodenum with abrupt narrowing caused by web (line).

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  Fig. 3 (A) We found transition zone grossly. (B) We did enterotomy at the 1st portion. Duodenal web was visible and 8 Fr foley catheter was inserted via web opening. (C) We did duodenoduodenostomy.

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