Related Experiment Video
Updated: Aug 5, 2025
10:41
Robotic D3 Partial Duodenal Resection with Primary Side-to-Side Anastomosis
Published on: December 15, 2023
1.9K
Delayed presentation of duodenal atresia
Charu Tiwari1, Nitinkumar Bhajandas Borkar1, Sunita Singh1
1Department of Paediatric Surgery, AIIMS, Raipur, Chhattisgarh, India.
African Journal of Paediatric Surgery : AJPS
|March 24, 2023
Summary
Fenestrated duodenal webs, a type of duodenal atresia, can cause delayed symptoms in infants. This study reviewed six cases, highlighting diagnostic challenges and proposing a classification modification for better diagnosis.
Area of Science:
- Pediatric Surgery
- Congenital Anomalies
- Gastrointestinal Surgery
Background:
- Duodenal atresia (DA), specifically Type I (duodenal web/membrane), can manifest later in infancy or childhood if fenestrated.
- Delayed presentation of DA due to fenestrated duodenal webs poses diagnostic challenges for pediatric surgeons.
- This study focuses on six pediatric patients with delayed presentation of DA caused by fenestrated webs.
Purpose of the Study:
- To describe the clinical characteristics and management of pediatric patients with delayed presentation of duodenal atresia due to fenestrated duodenal webs.
- To highlight the diagnostic challenges associated with fenestrated duodenal webs.
- To propose a modification to the existing classification of duodenal atresia for improved epidemiological reporting and early diagnosis.
Main Methods:
- Retrospective review of hospital records for six pediatric patients managed for delayed presentation of DA due to fenestrated webs.
- Data analysis included age at presentation, clinical symptoms, associated anomalies, radiological findings, intra-operative findings, surgical management, and postoperative outcomes.
- The study period spanned two years (January 2019 to December 2020) at a tertiary care institute.
Main Results:
- The median age of presentation was 6.5 months (range: 1 month to 10 years), with four males and two females.
- Emesis was the most common presenting symptom in all six patients.
- Fenestrated duodenal membranes (preampullary or postampullary) were confirmed intra-operatively in all patients, who underwent web excision with lateral duodenotomy and transverse closure. Postoperative recovery was uneventful with a mean hospital stay of 9 days.
Conclusions:
- Fenestrated duodenal webs present significant diagnostic challenges due to their variable and delayed clinical presentation in pediatric patients.
- A modified classification for DA is proposed to enhance the reporting of epidemiology and facilitate earlier diagnosis of this congenital anomaly.
- Surgical management involving web excision is effective, leading to favorable postoperative outcomes.
Related Concept Videos
01:28Esophageal Perforation-II: Clinical Manifestations and Management
109
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
109
01:22Esophageal Perforation-I: Introduction
141
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
141
01:26Esophageal Strictures-II: Clinical Features and Management
127
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
127