Down syndrome is present in 30% of cases, malrotation in 20%, and congenital heart diseases in 20% of cases. Check related conditions for additional relevant tests. Congenital duodenal obstruction, a common complication of down syndrome, most often presents as neonatal bilious vomiting. Its association with multiple anomalies is rare and scarcely reported in literature. Pdf duodenal atresia with major duodenal papilla within. In more than half of the patients with duodenal atresia, associated anomalies and syndromes are present.
Anatomic factors such as duodenal retroperitoneal fixation, position in front of the vertebral column, the rich submucosal and subserosal vascular plexus, and a weak muscular abdominal wall, are all contributory to the development of idh. In 3052% of infants it is an isolated anomaly, but it is often associated with. Herein 3 cases of duodenal atresia associated with multiple congenital anomalies are being reported. Paraduodenal pancreatitis is a distinct clinicopathological entity involving the duodenum and the pancreatic tissue in the vicinity of the minor papilla. Isolated duodenal perforation idp in pediatric trauma is rarely reported. Duodenal atresia is the congenital absence or complete closure of a portion of the lumen of the duodenum due to the defective fusion of foregut and midgut with failure of the recanalisation. Since most of the children with blunt trauma are managed expectantly, timely diagnosis is imperative to avoid morbidity and mortality. Wilson daza paula agudelo, esperanza paez silvana dadan s. The children came from a population of approximately 100,000 children over a 10year period. Most smallbowel adenocarcinomas arise from the duodenum or proximal small bowel, and close attention.
The incidence of duodenal atresia is between 110,000 and 16,000 live births, with an approximately equal male to female ratio. Duodenal atresia is a condition commonly identified in new born infants as it a congenital disorder. One of the three different types of duodenal mucosa, a transitional type, is also known. Feb 01, 2009 duodenal atresia is an embryopathy of the cranial intestine that leads to a complete absence of the duodenal lumen. We describe three cases of duodenal stenosis due to periduodenal hematoma with similar clinical courses. Duodenal hematoma following endoscopic duodenal biopsy. A congenital malformation characterized by the absence of a normal opening in a part of the duodenum.
Strict radiological and clinical criteria were observed in making this diagnosis. The diagnosis characteristic of the duodenitis was examined. Puede estar afectado cualquier sitio del tubo digestivo, su localizacion mas frecuente es yeyuno e ileon. Traumatic intramural duodenal hematoma idh in children occurs in 2 to 3% of blunt abdominal trauma 1, 2. Although clinical presentations should vary among causes, symptoms of duodenal stenosis due to periduodenal hematoma commonly include abdominal pain, nausea, or vomiting. Radiography shows a distended stomach and distended duodenum, which are separated by the pyloric valve, a finding described as the doublebubble sign. However the pathogenesis of the condition and its relationship with acute pancreatitis remain unknown. The overall mortality was 32%, although it fell from 39% in the. Malformaciones congenitas digestivas pediatria integral. We report a case of idp and emphasize on certain specific clinical features indicating possibility of duodenal injury. Chapter 62 duodenal atresia and stenosis felicitas eckoldtwolke afua a. Stomach and duodenum is decompressed by a small nasogastric tube.
Duodenal atresia with major duodenal papilla within duodenal atretic segment. An isolated duodenal perforation in pediatric blunt. Hesse sanjay krishnaswami introduction congenital duodenal obstruction may be due to intrinsic or extrinsic lesions. Is computed tomography a useful adjunct to the clinical examination for the diagnosis of pediatric gastrointestinal perforation from blunt abdominal trauma in children. Duodenal hematoma is a rare complication of endoscopic duodenal biopsy that occurs mainly in children or adults with impaired coagulation.
Duodenal atresia is an embryopathy of the cranial intestine that leads to a complete absence of the duodenal lumen. Duodenal atresia is the congenital absence or complete closure of a portion. A case report article pdf available in journal of pediatric surgery case reports 25 may 2014 with 36 reads. At surgery 7085% of gastrinomas are found in the right upper quadrant duodenal and pancreatic head area, the socalled gastrinoma triangle 4, 5. These three types are known as the transitionaltype duodenal mucosa, duodenal mucosa and jejunatype duodenal mucosa. Obstrucao duodenal etiologia, patofisiologia, sintomas, sinais, diagnostico e prognostico. The studies show that the three different types of the mucosa differ with each other on the basis of their susceptibility. We present a case of spontaneous intramural duodenal hematoma and a case of. The typical presentation is bilious vomiting within the first hour of birth. Ccap volumen 9 numero 1 45 wilson daza paula agudelo esperanza paez silvana dadan s. An isolated duodenal perforation in pediatric blunt abdominal. Nontraumatic intramural duodenal hematoma can cause upper gastrointestinal tract obstruction, upper gastrointestinal hemorrhage, jaundice, and pancreatitis and may be present in patients with normal coagulation. Prenatal ultrasonography makes possible an early diagnosis and treatment with better survival. Most afflicted patients are young alcoholic males who present clinically with upper abdominal pain, weight loss, nausea, and vomiting.
Duodenal atresia has been reported in association with various malformations and syndromes common being down syndrome, malrotation, and annular pancreas. It causes increased levels of amniotic fluid during pregnancy polyhydramnios and intestinal obstruction in newborn babies. A characteristic finding of duodenal obstruction is the doublebubble image of an airfilled stomach proximal to an airfilled first portion of the duodenum. Multidisciplinary management of patients with esophageal atresia. Duodenal atresia is a comparative emergency but time should be spent in evaluation, stabilization, and rehydration. Evaluation and management of traumatic liver, pancreas, and splenic injuries in children are discussed separately. Duodenal stenosis due to periduodenal hematoma is a rare condition. Intestinal atresia is the main cause of obstruction in the digestive tract in newborn.
Atlas of fetal duodenal atresia by mri, beth israel deaconess medical center duodenal atresia sonography of this 35 week fetus demonstrates the double bubble sign characteristic of duodenal atresia as well as polyhydramnios. The duodenal mucosa suffers from the small and inveterate duodenal ulcers. As soon as the baby takes the first few feeds, there is visible distention of the stomach and as there is duodenal atresia complete or partial the food regurgitates back into the stomach and the esophagus causing. Obstruccion duodenal en pacientes pediatricos medigraphic. In 2540% of cases, the anomaly is encountered in an infant with trisomy 21 down syndrome. Gastric and duodenal ulcers cannot be differentiated based on history alone, although some findings may be suggestive. Atresia esofagica y duodenal by sandra carolina monroy. O duodeno pode ser obstruido por estenose, atresia e por pressao. Aug 09, 2016 when duodenal atresia is suspected, erect and recumbent plain radiography of the abdomen should be the first imaging study obtained.
The price is significantly lower at surgery centers in mexico, where the level of patient care and safety standards are rising. One hundred and twentyeight of 3 41% patients with duodenal injuries underwent the procedure, with a duodenal fistula rate of 5. This appears to mildly displace the adjacent head of pancreas and superior mesenteric vein and mildly compress the underlying inferior vena cava. Fortynine cases of duodenal ulcer in children are presented. Sep 09, 20 therapy operation surgical correction of duodenal obstruction is not urgent prior to the mid 1970s, duodenojejunostomy was the preferred technique for correcting duodenal atresia or stenosis various techniques. Duodenal atresia genetic and rare diseases information. Gastrinoma duodenal and pancreatic neuroendocrinology 2006. Susana gonzalez gurrola abril, 2017 atresia intestinal 2. Relatively speaking, congenital duodenal atresia is one of the more common intestinal anomalies treated by pediatric surgeons, occurring 1 in 25005000 live births. We also stress upon the role of early contrastenhanced. Imaging of groove pancreatitis duodenal adenocarcinoma these tumors can be quite difficult to differentiate from groove pancreatitis, especial ly when they present as focal thickening of the medial duodenal wall.
Epigastric pain is the most common symptom of both gastric and duodenal ulcers and is characterized by a gnawing or burning sensation occurring shortly after meals with gastric ulcer and 23 hours afterward with duodenal ulcer. Gastroduodenal definition of gastroduodenal by medical. Multidisciplinary management of patients with esophageal. There are three different types of histological duodenal mucosa are present in normal human body. Duodenal atresia is the congenital absence or complete closure of a portion of the lumen of the duodenum. Ulcere gastroduodenal societe gi 1 lulcere gastroduodenal est une plaie ou une lesion trouvee dans.