Congenital intrinsic duodenal obstruction: Clinical study and predictors of neonatal surgical mortality

Authors

  • Dr. Pramila Sharma SMS Medical College, Jaipur
  • Dr. Naresh Pawar SMS Medical College, Jaipur
  • Dr. Arun Kumar Gupta SMS Medical College, Jaipur

DOI:

https://doi.org/10.47338/jns.v11.1034

Keywords:

Congenital duodenal obstruction, Duodenal atresia, Duodenal web, Duodenoduodenostomy, Neonatal surgical mortality

Abstract

Background: This study was aimed to analyze the clinical profile and the predictors of neonatal surgical mortality of congenital intrinsic duodenal obstruction (CIDO).

Methods: This is a case series of 67 patients with CIDO (duodenal atresia and stenosis) admitted at our teaching institute, from October 2018 to June 2020. The demographic data, clinical presentation, diagnostic methods, location & type of duodenal atresia, the operative procedure performed, and neonatal surgical mortality (NSM) predictors such as birth weight, age on presentation, associated anomalies, duration of surgery, extubation after surgery, sepsis, and vasopressors support were analyzed.

Results: Of 67 patients, 40(60%) were premature; mean weight and age at presentation were 2.06±0.6 (1-8 kg) and 6.7(1-240days), respectively. The majority of patients (59, 88%) presented with vomiting, and the most common finding on the x-ray abdomen was a double bubble sign (54, 81%). Twenty-four (36%) were associated with congenital heart disease and 19(28%) had Down’s syndrome. Type 3 duodenal atresia was the commonest finding in 43(64%) followed by type 1 in 22 (33%), and type 2 in 2(3%). In 49 (73%) Kimura’s duodenoduodenostomy, excision of web & duodenoplasty in 13 (19%), and side to side duodenoduodenostomy in 4 (6%), were performed. The mean hospital stay of survivors was 9 days. Overall survival was 63%.

Conclusion: Type 3 duodenal atresia is the commonest variety observed. The prematurity, low birth weight, associated major congenital anomalies, surgery >90 minutes, delayed extubation after surgery, sepsis, and need for vasopressors support are significant predictors of NSM.

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Author Biographies

Dr. Pramila Sharma, SMS Medical College, Jaipur

ASSOCIATE PROFESSOR, DEPT. OF PAEDIATRIC SURGERY

Dr. Naresh Pawar, SMS Medical College, Jaipur

SENIOR RESIDENT, DEPARTMENT OF PAEDIATRIC SURGERY

Dr. Arun Kumar Gupta, SMS Medical College, Jaipur

SENIOR PROFESSOR, DEPT. OF PAEDIATRIC SURGERY

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Published

2022-02-20

How to Cite

1.
Sharma P, Pawar N, Gupta AK. Congenital intrinsic duodenal obstruction: Clinical study and predictors of neonatal surgical mortality. J Neonatal Surg [Internet]. 2022Feb.20 [cited 2022Dec.3];11:9. Available from: https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/1034

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