Abstract
Congenital duodenal obstruction (DO) has a well-known association with Down syndrome (DS) and other congenital malformations. Previously reported series on DO have not examined the influence of DS on associated congenital malformations and postoperative morbidity and mortality. We report on a retrospective study of all children born with DO over an 11-year period to investigate this. A total of 79 patients with DO were studied: group 1 consisted of 51 (64.6%) children without DS, and group 2 consisted of 28 (35.4%) children with DS. There was no significant difference in mean gestational age and birth weight between groups 1 and 2. A coexisting congenital malformation was found in 68% of patients. Gastrointestinal malformations were the most common in group 1 (71.1%), and cardiac malformations were the most common in group 2 (81.5%). The mean time to reach full intragastric feeds was 12 days, with no significant difference between the two groups (p=0.383). Seven (8.9%) patients developed a postoperative complication, with no significant difference between both groups (p=0.853). A total of 11 patients died: six (12%) in group 1 and five (28%) in group 2, with no significant difference between the groups (p=0.454). DS does not influence the morbidity and mortality of DO but does carry a higher incidence of congenital cardiac abnormalities. Delayed mortality was a result of coexisting congenital cardiac and respiratory disease.
Similar content being viewed by others
References
Nixon HH (1989) Duodenal atresia. Br J Hosp Med 41:134–140
Bailey PV, Tracy TF, Connors RH, Mooney DP, Lewis JF, Weber TR (1993) Congenital duodenal obstruction: a 32-year review. J Pediatr Surg 28:92–95
Grosfeld JL, Ballantine TVN, Shoemaker R (1979) Operative management of intestinal atresia and stenosis based on pathological findings. J Pediatr Surg 14:368–375
Kimble RM, Harding J, Kolbe A (1997) Additional congenital anomalies in babies with gut atresia or stenosis: when to investigate, and which investigation. Pediatr Surg Int 12:565–570
Dalla Vecchia LK, Grosfeld JL, West KW, Rescorla FJ, Scherer LR, Engum SA (1998) Intestinal atresia and stenosis: a 25-year experience with 277 cases. Arch Surg 133:490–497
Torfs CP, Christianson RE (1998) Anomalies in Down syndrome individuals in a large population-based registry. Am J Med Genet 77:431–438
Källèn B, Mastroiacovo P, Robert E (1996) Major congenital malformations in Down syndrome. Am J Med Genet 65:160–166
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 106:1197–1199
Grosfeld JL, Rescorla FJ (1993) Duodenal atresia and stenosis: reassessment of treatment and outcome based on antenatal diagnosis, pathological variance and long-term follow-up. World J Surg 17:301–309
Wesley JR, Mahour GH (1977) Congenital intrinsic duodenal obstruction: a twenty-five year review. Surgery 82:716–720
Rescorla FJ, Grosfeld JL (1985) Intestinal atresia and stenosis: analysis of survival in 120 cases. Surgery 98:668–676
Spigland N, Yazbeck S (1990) Complications associated with surgical treatment of congenital intrinsic duodenal obstruction. J Pediatr Surg 25:1127–1130
Kokkonen ML, Kalima T, Jääskeläinen J, Louhimo I (1988) Duodenal atresia: late follow-up. J Pediatr Surg 23:216–220
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Singh, M.V.A., Richards, C. & Bowen, J.C. Does Down syndrome affect the outcome of congenital duodenal obstruction?. Ped Surgery Int 20, 586–589 (2004). https://doi.org/10.1007/s00383-004-1236-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-004-1236-1