Duodenal atresia with absence of superior mesenteric artery and apple peel appearance of small gut: A case report

Authors

  • Samiul Hasan Department of Pediatric Surgery, Dhaka Shishu (Children) Hospital, Bangladesh https://orcid.org/0000-0001-5470-2241
  • Dr. Jiaul Reza Dhaka Shishu (Children) Hospital
  • Dr. Fatema Sayeed Dhaka Medical College Hospital

DOI:

https://doi.org/10.47338/jns.v9.566

Keywords:

Duodenal atresia, Apple peel atresia, Bishop Koop enterostomy

Abstract

Background: Though duodenal atresia is relatively common among intestinal atresias, its association with apple peel type of jejunoileal atresia and absent superior mesenteric artery (SMA) is very rare. This association contradicts the well-known embryo pathology of duodenal atresia and could be a management challenge.

Case presentation: A 4-day-old preterm male baby presented with bilious vomiting. The X-ray abdomen showed a double bubble sign. Laparotomy revealed atresia of the 3rd part of the duodenum. The SMA was absent and the remaining small gut was short, narrow, and twisted around a narrow vascular pedicle arising from the marginal artery. We resected the most distal part of the dilated duodenum and made a wide end to side anastomosis with distal chimney stoma (Bishop Koop enterostomy). The baby did well in the postoperative period.

Conclusion: The surgical management of this rare entity was technically challenging. Bishop Koop enterostomy is a safe option when the primary anastomosis is not possible.

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Author Biographies

Samiul Hasan, Department of Pediatric Surgery, Dhaka Shishu (Children) Hospital, Bangladesh

Assistant Professor

Dr. Jiaul Reza, Dhaka Shishu (Children) Hospital

Resident, Pediatric Surgery

Dr. Fatema Sayeed, Dhaka Medical College Hospital

Registrar, Pediatric Surgery

References

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Published

2020-10-05

How to Cite

1.
Hasan S, Reza J, Sayeed F. Duodenal atresia with absence of superior mesenteric artery and apple peel appearance of small gut: A case report. J Neonatal Surg [Internet]. 2020Oct.5 [cited 2020Oct.27];9:23. Available from: https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/566

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