Abstract

Objective: Congenital duodenal obstructions consitute the majority of intestinal obstructions in the neonatal period. Although, morbidity and mortality have decreased significantly with preoperative and postoperative neonatal intensive care and appropriate nutritional therapies, it is seen that there are no studies comparing the interventions in duodenal obstructions over time. In our study, we aimed to examine the process of treatment of congenital duodenal obstruction over time by comparing the clinical datas of cases with congenital duodenal obstruction in our clinic with the clinical information presented in the literature .

Material and Methods: Sixteen cases with congenital duodenal obstruction treated in our clinic between 2006-2016 were retrospectively reviewed for gestational age, gender, birth pain, application day, complaint, additional anomalies, operation time, surgery, feeding time, length of stay and follow-up. The current status of congenital duodenal obstruction therapy is discussed.

Results: Nine boy, 7 girl cases, %69 of cases were premature. The mean gestational age was 34.8 (29-40) weeks. Clinical complaints were vomiting in 11 cases, abdominal distension in 4 cases, and general condition disorder in one case. Eight cases had congenital heart disease, five cases had Down’s syndrome and two cases had malrotation. Diamond-Shape Duodenoduodenostomy was performed in 12 cases as the most common surgical method. The mean total parenteral nutrition (TPN) period was 8.4 days and mean hospitalization time was 17.56 days. All patients were discharged with full recovery without any surgical complication.

Conclusion: In literature review, it was seen that surgical processes were given cross-sectional but detailed examinations of the disease were less. In the comparisons, it was seen that the mortality decreased significantly over time but there was no change in the mean of surgical techniques and mean of starting day to feeding.
Remarkably, an increase in sepsis rates was observed. The majority of cases in the literature are prematurity cases, long hospital stays and relatively low immunities of these cases may explain the increase in sepsis rates. In this situation, we suggest that determinate the better service conditions and more detailed correlation studies should be performed between postoperative enteral and parenteral nutrition and mortality and morbidity. 

Keywords: Congenital duodenal obstruction, Neonatal, Intensive care

References

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1.
Öztorun Cİ, Ertürk A, Demir S, Güney D, Şenaylı A, Azılı MN. Clinical Approach to Congenital Duodenal Obstructions. Turk J Pediatr Dis [Internet]. 2021 Jan. 22 [cited 2025 May 24];15(1):43-7. Available from: https://turkjpediatrdis.org/article/view/820