Double duodenal webs in an adult

The duodenal web is an unusual cause of gastric outlet obstruction, but one that must be kept in mind in patients with postprandial nausea, vomiting, and epigastric pain. We suggest endoscopic evaluation of the second and third portions of the duodenum in all such patients. At surgery, direct inspection of the duodenal lumen or the confirmation of its patency by passage of a Foley balloon should be routine. If a duodenal web is encountered, the procedure of choice should be duodenostomy with simple excision of the web.