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Pediatric Surgery International

, Volume 20, Issue 8, pp 582–585 | Cite as

Congenital duodenal obstruction: does prenatal diagnosis improve the outcome?

  • Daniel Guimarães Bittencourt
  • Ricardo Barini
  • Sergio Marba
  • Lourenço Sbragia
Original Article

Abstract

Prenatal diagnosis of congenital duodenal obstruction (CDO) provides information about associated anomalies; helps plan the delivery, resuscitation, and neonatal surgery; and allows for appropriate family counseling. This report compares the outcomes of two groups of newborns: one with prenatal diagnosis of CDO (group I) and the other without (group II). Charts of the 23 newborns with CDO admitted to the Hospital of UNICAMP between 1993 and 2001 were retrospectively reviewed. Ten (44%) newborns had prenatal diagnosis of CDO. Among group I patients, the postnatal diagnosis was confirmed on the 1st day of life, whereas patients without prenatal diagnosis (group II) had the diagnosis of CDO confirmed at a mean age of 5.7 days (p=0.004). The mean ages at surgery, at total oral feeding, and at hospital discharge were also statistically lower among infants with prenatal diagnosis, and more complications occurred in group II patients. The earlier care could explain the statistically lower morbidity for patients with prenatal diagnosis, since they were able to undergo further investigation and surgical repair before any impairment to their clinical status could take place. We believe that prenatal diagnosis of CDO, associated with earlier surgery and adequate postoperative support, can provide lower morbidity, decrease the hospitalization period, and, therefore, decrease its costs to the state and to society.

Keywords

Congenital Duodenal obstruction Prenatal diagnosis Polyhydramnios Outcome 

References

  1. 1.
    Fonkalsrud EW (1979) Duodenal atresia or stenosis. In: Bergsma D (ed) Birth defects compendium. Liss, New York, p 350Google Scholar
  2. 2.
    Safra MJ, Oakley GP, Erikson JD (1976) Descriptive epidemiology of small bowel. Teratology 14:143–149PubMedGoogle Scholar
  3. 3.
    Grosfeld JL, Rescorla FJ (1993) Duodenal atresia and stenosis: reassessment of treatment and outcome based on antenatal diagnosis, pathologic variance, and long term follow-up. World J Surg 17:301–309PubMedGoogle Scholar
  4. 4.
    Fonkalsrud EW, de Lorimier AA, Hays DM (1969) Congenital atresia and stenosis of the duodenum. Pediatrics 43:79–83PubMedGoogle Scholar
  5. 5.
    Lynn HB (1969) Duodenal obstruction: atresia, stenosis, and annular pancreas. In: Mustard WT, Ravitch MM, Snyder WH, Welch RJ, Benson CD (eds) Pediatric surgery. Year Book Medical Publishers, Chicago, pp 800–808Google Scholar
  6. 6.
    Hausler MC, Berghold A, et al. (2002) Prenatal ultrasonographic detection of gastrointestinal obstruction: results from 18 European congenital anomaly registries. Prenat Diagn 22(7):616–623CrossRefPubMedGoogle Scholar
  7. 7.
    Lawrence MJ, Ford WDA, Furness ME, et al. (2000) Congenital duodenal obstruction: early antenatal ultrasound diagnosis. Pediatr Surg Int 16:342–345CrossRefPubMedGoogle Scholar
  8. 8.
    Ladd WE (1937) Congenital duodenal obstruction. Surgery 1:878–885Google Scholar
  9. 9.
    Tandler J (1902) Zur entwicklunggeschicte des menschlichen duodenums. Morphol Jb 29:187–216Google Scholar
  10. 10.
    Schnaufer L (1986) Duodenal atresia, stenosis and annular pancreas. In: Welch RJ, Randolph JG, Ravitch MM, et al. (eds) Pediatric surgery. Year Book, Chicago, pp 929–937Google Scholar
  11. 11.
    Ladd WE (1931) Congenital obstruction of the duodenum in children. N Engl Med 206:277–283Google Scholar
  12. 12.
    Akhtar J, Guiney EJ (1992) Congenital duodenal obstruction. Br J Surg 79:133–135PubMedGoogle Scholar
  13. 13.
    Mooney D, Lewis JE, Connors RH, et al. (1987) Newborn duodenal atresia: an improving outlook. Am J Surg 153:347–349CrossRefPubMedGoogle Scholar
  14. 14.
    Young DG, Wilkinson AW (1968) Abnormalities associated with neonatal duodenal obstruction. Surgery 63:832–836PubMedGoogle Scholar
  15. 15.
    Atwell JD, Klidjian AM (1982) Vertebral anomalies and duodenal atresia. J Pediatr Surg 17:237–240Google Scholar
  16. 16.
    Bailey PV, Tracy TF, Connors RH, et al. (1993) Congenital duodenal obstruction: a 32-year review. J Pediatr Surg 28:92–95PubMedGoogle Scholar
  17. 17.
    Romero R, Ghidini A, Costigan K, et al. (1988) Perinatal diagnosis of duodenal atresia: does it make any difference? Obstet Gynaecol 71:739–741Google Scholar
  18. 18.
    Murshed R, Nicholls G, Spitz L (1999) Intrinsic duodenal obstruction: trends in management and outcome over 45 years (1951–1995) with relevance to prenatal counseling. Br J Obstet Gynaecol 106:1197–1199PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Daniel Guimarães Bittencourt
    • 1
  • Ricardo Barini
    • 2
  • Sergio Marba
    • 3
  • Lourenço Sbragia
    • 1
  1. 1.Division of Pediatric Surgery, Department of Surgery, School of Medical SciencesCampinas State University—UNICAMPCampinas—SPBrazil
  2. 2.Division of Fetal Medicine, Department of Obstetrics and GynecologyCampinas State University—UNICAMPCampinas—SPBrazil
  3. 3.Division of Neonatology, Department of PediatricsCampinas State University—UNICAMPCampinas—SPBrazil

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