Congenital duodenal membrane: a ten-year review

Traditionally, congenital duodenal membrane (CDM) has been classified as a type of duodenal atresia. To provide a better understanding of this disease entity, the experience of our 13 patients with congenital duodenal membrane treated from April 1988 to November 1998 is reported. Nine were boys and four were girls, including four prematures (31%). Late diagnosis was made in eight babies and led to prolonged hospitalization (mean 20 days), although duodenal obstruction was demonstrated by barium study in all 13 patients. The low frequency of bilious vomiting (46%) and abdominal distention (39%), and lack of definite findings on plain abdominal X-ray and abdominal ultrasonography, have contributed to the delayed diagnosis in our patients. Nevertheless, no major complications developed after web excision with duodenoplasty, and satisfactory weight gain was noted in all patients except the two with Down syndrome. Since CDM is often overlooked, a better understanding of this disease entity can prevent delayed diagnosis, growth retardation and prolonged hospitalization.