[Experiences with congenital duodenal obstruction in the Sophia Kinderziekenhuis]

In the department of Paediatric Surgery, Sophia Children's Hospital, University Hospital, Rotterdam, we investigated whether the presence of Down's syndrome influenced the chances of survival of patients with a congenital duodenal obstruction. The retrospective study comprised all 109 patients admitted to the Sophia Children's Hospital with a congenital duodenal obstruction in the period 1971-1989. The additional presence of Down's syndrome itself did not influence the prognosis. The presence of other additional anomalies (especially cardiac anomalies) did influence the mortality rate. In the past these anomalies--which are present more frequently in association with Down's syndrome--were responsible for the higher mortality in children with both a congenital duodenal obstruction and Down's syndrome. We conclude that with the availability of the current medical (especially cardio-surgical) techniques, it may be expected that the mortality rate of duodenal obstruction will be the same in patients with and without Down's syndrome (10%). Only non-medical, non-technical arguments can be of overriding importance in the decision whether a newborn child suffering from both a duodenal obstruction and Down's syndrome will or will not be operated on.