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Congenital duodenal web in late infancy and childhood: a report of two cases
1Department of Pediatrics, Taiwan Provincial Feng Yuan Hospital, Taichung, R.O.C.
Insights
Congenital duodenal webs, rare causes of intestinal obstruction, can present in infancy or later in life. Surgical web excision effectively resolves symptoms in pediatric and adolescent patients.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Congenital Malformations
Background:
- Congenital duodenal webs are uncommon congenital anomalies leading to duodenal obstruction.
- Presentation varies, with diagnosis typically occurring in infancy but sometimes delayed until adolescence or adulthood.
Observation:
- Two cases are presented: a 6-month-old infant with vomiting and abdominal distention, and a 13-year-old boy with nonspecific symptoms including seizures and renal dysfunction.
- The latter case highlights the potential for atypical presentations of duodenal webs.
Findings:
- Both patients underwent successful duodenotomy and web excision.
- Complete symptom resolution was achieved in both cases post-operatively.
Implications:
- Congenital duodenal webs require surgical intervention for resolution.
- Delayed diagnosis is possible, necessitating consideration in the differential diagnosis of gastrointestinal and even neurological/renal symptoms in older children and adolescents.
Abstract:
Congenital duodenal webs are rare lesions, usually detected during early infancy because of signs of high intestinal obstruction. The occasional patient escapes both symptoms and detection until adolescence or adulthood. This report concerns two cases of congenital duodenal web at different ages and with different clinical manifestations. Case 1, a six-month-old male, was admitted because of abdominal distention and vomiting. Case 2, a 13-year-old boy, was referred here for further evaluation of recurring seizure attacks, elevated blood urea nitrogen and creatinine and hyponatremia. Duodenotomy and excision of the web performed for both patients. Complete amelioration of all symptoms was then observed at Outpatient Clinic follow-up for one year.