Duodenal webs: an experience with 18 patients

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Congenital Anomalies

Background:

• Congenital duodenal webs are rare malformations causing upper gastrointestinal obstruction in infants.
• Diagnosis can be challenging, leading to delayed management and potential complications.

Purpose of the Study:

• To review the management and outcomes of patients with congenital duodenal webs.
• To highlight diagnostic challenges and factors influencing patient outcomes.

Main Methods:

• Retrospective case series of 18 patients with congenital duodenal webs.
• Analysis of demographic data, clinical presentation, associated anomalies, management, and outcomes.
• Data collected from 1999 to 2011.

Main Results:

• Median age at presentation was 8 days; only 2 patients had antenatal diagnosis.
• Bilious vomiting was the most common symptom; 8 patients had associated anomalies (e.g., malrotation, Down's syndrome).
• Diagnosis was missed in 5 patients operated for other conditions; mortality rate was 22% due to sepsis, prematurity, and anomalies.

Conclusions:

• Congenital duodenal webs are often misdiagnosed, particularly fenestrated types.
• Timely presentation and management of associated anomalies are crucial for better outcomes.
• Trans-anastomotic tube feeding is a practical alternative to total parenteral nutrition for nutritional support.