[Duodenal atresia]

The article deals with 5-year (1986-1992) experience in the diagnosis and treatment of duodenal atresia in 26 infants. Timely diagnosis of this developmental anomaly, the variants of operative treatment, and the principles of postoperative management are discussed. The necessity of antenatal ultrasonic examination and the high diagnostic value of radiological and endoscopic methods of diagnosis are emphasized. Operations were conducted on 25 children for total high intestinal obstruction, on 23 infants in the neonatal period. The continuity of the intestinal tube was restored by duodenoduodenostomy (12), duodenojejunostomy (3), gastroduodenostomy (1), excision of the membrane (4), and dissection of the membrane (5). The latter is technically the simplest and is the operation of choice. Preliminary jejunostomy for adequate preparation for the radical operation is recommended in profoundly preterm infants with as serious premorbid background. Of high importance is postoperative enteral catheteral feeding which is begun from the first day after the operation. Seven out of the 26 patients died from severe combined developmental anomalies and infection. The mortality was 26.9%.