Familial congenital duodenal obstruction

Duodenal webs are an uncommon cause of duodenal stenosis arising from incomplete bowel recanalisation during embryological development. Despite troubling symptoms such as bilious vomiting in affected infants, prognosis is generally favourable when promptly recognised and treated surgically. Though the condition is recognised as embryological in origin, evidence for familial predisposition is lacking in the medical literature. The authors present a case of duodenal web and concurrent annular pancreas with a positive family history of congenital duodenal obstruction in the infant's father. We discuss how knowledge of familial occurrence of the condition can promote early diagnosis after birth and propose the potential role for preconception genetic counselling for parents with a personal or family history of congenital duodenal obstruction.