Duodenal atresia and stenosis

Long-term follow-up over 30 years

Mauricio A. Escobar, Alan P. Ladd, Jay L. Grosfeld, Karen W. West, Frederick Rescorla, L. R. Scherer, Scott A. Engum, Thomas M. Rouse, Deborah F. Billmire

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Background Duodenal atresia and stenosis is a frequent cause of congenital, intestinal obstruction. Current operative techniques and contemporary neonatal critical care result in a 5% morbidity and mortality rate, with late complications not uncommon, but unknown to short-term follow-up. Methods A retrospective review of patients with duodenal anomalies was performed from 1972 to 2001 at a tertiary, children's hospital to identify late morbidity and mortality. Results Duodenal atresia or stenosis was identified in 169 patients. Twenty children required additional abdominal operations after their initial repair with average follow-up of 6 years (range, 1 month to 18 years) including fundoplication (13), operation for complicated peptic ulcer disease (4), and adhesiolysis (4). Sixteen children underwent revision of their initial repair: tapering duodenoplasty or duodenal plication (7), conversion of duodenojejunostomy to duodenoduodenostomy (3), redo duodenojejunostomy (3), redo duodenoduodenostomy (2), and conversion of gastrojejunostomy to duodenoduodenostomy (1). There were 10 late deaths (range, 3 months to 14 years) attributable to complex cardiac malformations (5), central nervous system bleeding (1), pneumonia (1), anastomotic leak (1), and multisystem organ failure (2). Conclusions Late complications occur in 12% of patients with congenital duodenal anomalies, and the associated late mortality rate is 6%, which is low but not negligible. Follow-up of these patients into adulthood is recommended to identify and address these late occurrences.

Original languageEnglish
Pages (from-to)867-871
Number of pages5
JournalJournal of Pediatric Surgery
Volume39
Issue number6
DOIs
StatePublished - Jun 2004

Fingerprint

Mortality
Morbidity
Fundoplication
Anastomotic Leak
Gastric Bypass
Intestinal Obstruction
Critical Care
Peptic Ulcer
Tertiary Care Centers
Pneumonia
Central Nervous System
Hemorrhage
Familial duodenal atresia

Keywords

  • Duodenal atresia and stenosis
  • duodenal dysmotility
  • gastroesophageal reflux disease
  • megaduodenum
  • tapering duodenoplasty

ASJC Scopus subject areas

  • Surgery

Cite this

Escobar, M. A., Ladd, A. P., Grosfeld, J. L., West, K. W., Rescorla, F., Scherer, L. R., ... Billmire, D. F. (2004). Duodenal atresia and stenosis: Long-term follow-up over 30 years. Journal of Pediatric Surgery, 39(6), 867-871. https://doi.org/10.1016/j.jpedsurg.2004.02.025

Duodenal atresia and stenosis : Long-term follow-up over 30 years. / Escobar, Mauricio A.; Ladd, Alan P.; Grosfeld, Jay L.; West, Karen W.; Rescorla, Frederick; Scherer, L. R.; Engum, Scott A.; Rouse, Thomas M.; Billmire, Deborah F.

In: Journal of Pediatric Surgery, Vol. 39, No. 6, 06.2004, p. 867-871.

Research output: Contribution to journalArticle

Escobar, MA, Ladd, AP, Grosfeld, JL, West, KW, Rescorla, F, Scherer, LR, Engum, SA, Rouse, TM & Billmire, DF 2004, 'Duodenal atresia and stenosis: Long-term follow-up over 30 years', Journal of Pediatric Surgery, vol. 39, no. 6, pp. 867-871. https://doi.org/10.1016/j.jpedsurg.2004.02.025
Escobar, Mauricio A. ; Ladd, Alan P. ; Grosfeld, Jay L. ; West, Karen W. ; Rescorla, Frederick ; Scherer, L. R. ; Engum, Scott A. ; Rouse, Thomas M. ; Billmire, Deborah F. / Duodenal atresia and stenosis : Long-term follow-up over 30 years. In: Journal of Pediatric Surgery. 2004 ; Vol. 39, No. 6. pp. 867-871.
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abstract = "Background Duodenal atresia and stenosis is a frequent cause of congenital, intestinal obstruction. Current operative techniques and contemporary neonatal critical care result in a 5{\%} morbidity and mortality rate, with late complications not uncommon, but unknown to short-term follow-up. Methods A retrospective review of patients with duodenal anomalies was performed from 1972 to 2001 at a tertiary, children's hospital to identify late morbidity and mortality. Results Duodenal atresia or stenosis was identified in 169 patients. Twenty children required additional abdominal operations after their initial repair with average follow-up of 6 years (range, 1 month to 18 years) including fundoplication (13), operation for complicated peptic ulcer disease (4), and adhesiolysis (4). Sixteen children underwent revision of their initial repair: tapering duodenoplasty or duodenal plication (7), conversion of duodenojejunostomy to duodenoduodenostomy (3), redo duodenojejunostomy (3), redo duodenoduodenostomy (2), and conversion of gastrojejunostomy to duodenoduodenostomy (1). There were 10 late deaths (range, 3 months to 14 years) attributable to complex cardiac malformations (5), central nervous system bleeding (1), pneumonia (1), anastomotic leak (1), and multisystem organ failure (2). Conclusions Late complications occur in 12{\%} of patients with congenital duodenal anomalies, and the associated late mortality rate is 6{\%}, which is low but not negligible. Follow-up of these patients into adulthood is recommended to identify and address these late occurrences.",
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AU - Ladd, Alan P.

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AU - West, Karen W.

AU - Rescorla, Frederick

AU - Scherer, L. R.

AU - Engum, Scott A.

AU - Rouse, Thomas M.

AU - Billmire, Deborah F.

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N2 - Background Duodenal atresia and stenosis is a frequent cause of congenital, intestinal obstruction. Current operative techniques and contemporary neonatal critical care result in a 5% morbidity and mortality rate, with late complications not uncommon, but unknown to short-term follow-up. Methods A retrospective review of patients with duodenal anomalies was performed from 1972 to 2001 at a tertiary, children's hospital to identify late morbidity and mortality. Results Duodenal atresia or stenosis was identified in 169 patients. Twenty children required additional abdominal operations after their initial repair with average follow-up of 6 years (range, 1 month to 18 years) including fundoplication (13), operation for complicated peptic ulcer disease (4), and adhesiolysis (4). Sixteen children underwent revision of their initial repair: tapering duodenoplasty or duodenal plication (7), conversion of duodenojejunostomy to duodenoduodenostomy (3), redo duodenojejunostomy (3), redo duodenoduodenostomy (2), and conversion of gastrojejunostomy to duodenoduodenostomy (1). There were 10 late deaths (range, 3 months to 14 years) attributable to complex cardiac malformations (5), central nervous system bleeding (1), pneumonia (1), anastomotic leak (1), and multisystem organ failure (2). Conclusions Late complications occur in 12% of patients with congenital duodenal anomalies, and the associated late mortality rate is 6%, which is low but not negligible. Follow-up of these patients into adulthood is recommended to identify and address these late occurrences.

AB - Background Duodenal atresia and stenosis is a frequent cause of congenital, intestinal obstruction. Current operative techniques and contemporary neonatal critical care result in a 5% morbidity and mortality rate, with late complications not uncommon, but unknown to short-term follow-up. Methods A retrospective review of patients with duodenal anomalies was performed from 1972 to 2001 at a tertiary, children's hospital to identify late morbidity and mortality. Results Duodenal atresia or stenosis was identified in 169 patients. Twenty children required additional abdominal operations after their initial repair with average follow-up of 6 years (range, 1 month to 18 years) including fundoplication (13), operation for complicated peptic ulcer disease (4), and adhesiolysis (4). Sixteen children underwent revision of their initial repair: tapering duodenoplasty or duodenal plication (7), conversion of duodenojejunostomy to duodenoduodenostomy (3), redo duodenojejunostomy (3), redo duodenoduodenostomy (2), and conversion of gastrojejunostomy to duodenoduodenostomy (1). There were 10 late deaths (range, 3 months to 14 years) attributable to complex cardiac malformations (5), central nervous system bleeding (1), pneumonia (1), anastomotic leak (1), and multisystem organ failure (2). Conclusions Late complications occur in 12% of patients with congenital duodenal anomalies, and the associated late mortality rate is 6%, which is low but not negligible. Follow-up of these patients into adulthood is recommended to identify and address these late occurrences.

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