Congenital intrinsic duodenal obstruction: a twenty-five year review

From 1951 through 1975, 72 patients with congenital intrinsic duodenal obstruction were seen at the Childrens Hospital of Los Angeles. The survival rate was 55% during the first 15 years of the study, but this has increased to 88% during the last 10 years. Factors important to this increased survival rate include: earlier diagnosis and expeditious preoperative workup; expert administration of anesthesia; improved surgical technique with a greater awareness for common pitfalls, such as associated duodenal diaphragm or distal bowel atresia; frequent use of gastrostomy; use of parenteral nutrition; and better intensive nursing care.