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Persistent Nonbilious Vomiting in a Child: Possible Duodenal Webbing

Rossella Angotti1, Francesco Molinaro1, Giovanni Cobellis2

  • 1Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.

Clinical Endoscopy
|October 13, 2016
PubMed

Insights

Congenital duodenal webbing is rarely associated with malrotation. This study highlights the importance of considering duodenal pathology in children with nonbilious vomiting, even when malrotation is present.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Malformations

Background:

  • Malrotation and congenital duodenal webbing are distinct gastrointestinal anomalies.
  • Their co-occurrence is exceptionally rare in pediatric surgical literature.

Purpose of the Study:

  • To report on the rare association of malrotation with congenital duodenal webbing.
  • To emphasize the diagnostic considerations for this condition.

Main Methods:

  • Presentation of a case series of four patients with malrotation and duodenal webbing from two institutions.
  • Comprehensive review of existing published reports on this specific pathology.

Main Results:

  • The study identified 94 reported cases of duodenal pathology associated with malrotation.
  • Only 15 of these cases (15.9%) specifically involved both malrotation and a duodenal web.
  • This highlights the infrequent nature of this combined presentation.

Conclusions:

  • Nonbilious vomiting in pediatric patients warrants consideration of duodenal pathology.
  • Surgeons should maintain a high index of suspicion for duodenal webs even in the presence of known malrotation.
Keywords:
ChildCongenital duodenal webMalrotationNonbilious vomiting

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