Presentation
Our patient presented at the age of 5 months, outside of the immediate neonatal period, and with the atypical presenting sign of hematemesis. [ncbi.nlm.nih.gov]
Entire Body System
- Trisomy 21
Trisomy 21. 4. Feingold syndrome (oculodigitoesophago-duodenal syndrome) (6): - Microcephaly, tracheo-esophageal fistula and mesobrachyphalangy. 5. [fetalultrasound.com]
Associated with trisomy 21 in 30% of cases. Amniocentesis should be performed. Associated with congenital heart disease in 17% to 33% of cases. Echocardiography should be performed. [mhmedical.com]
About 10% of duodenal webs found in childhood are associated with other congenital conditions such as trisomy 21, intestinal malrotation, situs inversus, congenital heart disease, or annular pancrease[8]. [ghrnet.org]
Type III atresias have an obvious gap separating the proximal and distal duodenal segments. 27 More than 50% of affected patients with duodenal atresia have associated congenital anomalies. 28 Approximately 30% are associated with trisomy 21, 30% with [clinicalgate.com]
- Surgical Procedure
All surgical procedures of balloon dilatation were performed under direct gastroscopic vision. [ncbi.nlm.nih.gov]
Prior to surgery hydroelectrolitique reequlibration is needed The surgical procedure depends on the malformation Diaphragm: longitudinal duodenectomy Annular pancreas: diamond shaped duodeno-duodenal anastomosis Ladd's syndrome: resection and decompresion [pathologyreviewer.blogspot.com]
Once the child is stabilized, a surgical procedure is performed to bypass the obstruction. We performed the duodenojejunostomy anastomosis for the first sister and duodenoduodenostomy for the second sister. [saudisurgj.org]
Also it signifies the extended value of minimal invasive surgery in children to perform a thorough inspection of abdomen in presence of symptoms unrelated to known cause or previous surgical procedures. [file.scirp.org]
Laparoscopic Laparoscopic pyloromyotomy has been demonstrated as a safe approach with results at least equivalent to the open surgical procedure and may result in decreased time to full feeding, less perioperative pain, and a superior long-term cosmetic [basicmedicalkey.com]
- Falling
Ramnik Patel, Isaac Philip Department of Paediatric Surgery, The Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, UK Correspondence: Isaac Philip Department of Paediatric Surgery The Royal Belfast Hospital for Sick Children 180, Falls [jpss.eu]
Among hospitalized anemic patients, studies have shown an increased likelihood of delirium, mobility disability and falls that often results in prolonged in-patient course. [benthamopen.com]
Respiratoric
- Aspiration
However, the patient continued to have high-bilious aspirates. A paediatric surgical opinion was requested. [casereports.bmj.com]
[…] distention in the eigastric region Normal meconium if the obstruction is superior to Vater's ampulla Acolic mucous secretion if the obstruction is inferior to Vater's ampulla Spirt vomiting, in high amounts Sings of dehydration: depressed fontanelle Gastric aspiration [pathologyreviewer.blogspot.com]
His initial post-operative period was uneventful and then he had nasogastric tube aspirates ranging from 400 to 750 ml in the following few days. [jpss.eu]
Aspiration via a nasogastric (NG) tube of more than 20 mL of gastric contents in a newborn suggests intestinal obstruction, as normal aspirate is less than 5 mL. 41 For patients with stenosis, the diagnosis is often delayed until the neonate has started [clinicalgate.com]
Other symptoms include saliva excess, failure to thrive and recurrent respiratory infections due to aspiration [ 4, 5, 6 ]. [jbsr.be]
- Respiratory Distress
Soon afterwards signs of respiratory distress and hypersalivation emerged. On serial thoracic X-ray, a progressive widening air column was seen projecting on the cervicothoracic area (Figure 1 ). [jbsr.be]
He had mild respiratory distress syndrome requiring nasal continuous positive airway pressure for six weeks in special care baby unit. [jpss.eu]
- Dyspnea
The patient is 71 year old female, who suffered from severe dyspnea, dry cough, intermittent wheezing. Also she had dry eyes, dry mouth, muscle weakness and intermittent pain in large joints, and low grade fever. [cyberleninka.ru]
Subsequently she presented with significant fatigue, dyspnea, weakness, dizziness, with difficulty walking and confusion after recurrent episodes of GI bleeds. [benthamopen.com]
Gastrointestinal
- Vomiting
He was initially treated for acute gastroenteritis, but vomiting resumed after starting oral ingestion. [ncbi.nlm.nih.gov]
If the defect is located proximal to the major duodenal papilla, nonbilious vomiting occurs, whereas a defect occurring distal to the papilla causes bilious vomiting. [amboss.com]
- Bilious Vomiting
If the defect is located proximal to the major duodenal papilla, nonbilious vomiting occurs, whereas a defect occurring distal to the papilla causes bilious vomiting. [amboss.com]
Preampullary lesions with non-bilious vomiting simulating gastric outlet obstruction has been reported recently [1]. [jpss.eu]
Case report – The patient is 2 year old aged girl with persistent non-bilious vomiting. She was vomiting several times a week, and over the ten days prior to presentation as many as several times a day. [cejpaediatrics.com]
Abdominal distention with bilious vomiting is observed within the first 24 hours after birth. [aafp.org]
[…] bowel distal to the obstruction No oral or rectal contrast is usually needed to diagnose duodenal atresia Double bubble may also be seen on prenatal ultrasounds Differential Diagnosis Malrotation with Ladd’s bands Bilious vomiting within 24 hours of [learningradiology.com]
- Nausea
A 61-year-old woman was admitted to our hospital complaining of abdominal fullness, epigastralgia, nausea, and vomiting. [ncbi.nlm.nih.gov]
Nausea and Vomiting Obstruction of the duodenum can also cause patients to become nauseated and vomit. [livestrong.com]
Vomiting with intense nausea and dull stomach pain is more likely with gastroenteritis. [telefot.eu]
- Failure to Thrive
A 10-month-old child affected by CRS with congenital hearth disease, perceptive deafness and microcephaly, was admitted because of vomiting and failure to thrive. [ncbi.nlm.nih.gov]
Vomiting and food refusal causing failure to thrive in a 2 year old: an unusual and late manifestation of congenital duodenal web. BMJ Case Reports 2011; doi:10.1136/bcr.01.2011.3779 6. Richardson WR, Martin LW. [jpss.eu]
Other symptoms include saliva excess, failure to thrive and recurrent respiratory infections due to aspiration [ 4, 5, 6 ]. [jbsr.be]
In some instances, duodenal stenosis goes unrecognized for long periods, leading to recurrent episodes of vomiting, failure to thrive, and aspiration pneumonia. [journals.lww.com]
- Constipation
Abstract We present a case of distal duodenal stenosis without a wind sock deformity in a Down’s syndrome presenting with non-bilious vomiting, constipation and bilious aspirates simulating Hirschsprung’s disease. [jpss.eu]
Symptoms include Severe abdominal pain or cramping Vomiting Bloating Loud bowel sounds Swelling of the abdomen Inability to pass gas Constipation A complete intestinal obstruction is a medical emergency. It often requires surgery. [icdlist.com]
Complete obstruction can result in constipation as well as the inability to pass gas. [livestrong.com]
She does have a history of intermittent constipation and required glycerin suppository as needed. An upper GI series was ordered and revealed a high grade obstruction in the proximal duodenum with malrotation. [ghrnet.org]
The clinical symptoms of a mesenteric lymphangioma are abdominal pain, vomiting, and constipation. [ncbi.nlm.nih.gov]
Cardiovascular
- Heart Murmur
There was systolic heart murmur in neonatal period and echocardiography showed small ventricular septal defect which closed spontaneously. He passed meconium in first 48 hours but then required daily suppositories to open bowels. [jpss.eu]
- Systolic Murmur
S1 and S2 heart sounds was soft to auscultation, diffuse systolic murmur grade II at all points was detected. [cyberleninka.ru]
Psychiatrical
- Suggestibility
This is the first endoscopic report of this lesion and the presence of the duodenal cervix sign should suggest the diagnosis of congenital duodenal stenosis. [ncbi.nlm.nih.gov]
Our findings suggest that duodenal ulceration and stenosis may be a more common complication of celiac disease than previously thought and may precede the clinical diagnosis of celiac disease or occur when there are minimal symptoms and nonspecific radiographic [mayoclinic.pure.elsevier.com]
Workup
The diagnostic preoperative workup should include a plain abdominal radiograph, upper and/or lower gastrointestinal contrast studies, and ultrasonography (1). [journals.lww.com]
Treatment
Endoscopic treatment is feasible in these patients. The long-term outcomes of endoscopic therapy need to be compared with surgical treatment. [ncbi.nlm.nih.gov]
At that time it was Germany's first medical institution specializing in the treatment of diabetes. [bookinghealth.com]
742 Laparoscopic Treatment of Nonpalpable Testis 753 Transperitoneal Laparoscopic Treatment of Varicocele 759 Oneport Retroperitoneoscopic Varicocelectomy in Children and Adolescents 765 Laparoscopy in Functional Ovarian Cysts in Neonates 771 Laparoscopy [books.google.de]
Prognosis
This classification generally guides prognosis and therapy (see the image below). Classification of jejunoileal atresias. [emedicine.medscape.com]
Prevention, and Complications Prognosis full recovery is expected after surgical correction Prevention no preventive measures are available at this time Complications without treatment, condition is lethal Please rate topic. [medbullets.com]
If left untreated, it is fatal Prognosis will depend on the presence of associated cardiac, tracheo-esophageal, anal, renal, or skeletal abnormalities (VATER) Double Bubble Sign. [learningradiology.com]
Neuroendocrine tumors (NETs) are characterized by having behavior and prognosis that depend upon tumor histology, primary site, staging, and proliferative index. [scinapse.io]
Etiology
Necrotizing enterocolitis was the most common (6/9) etiology of stricture. Ten of 11 patients did not require subsequent operative management although 3 children required further dilatations. [ncbi.nlm.nih.gov]
Etiology Multiple theories regarding the etiology of jejunoileal atresia have been studied in many animal models (eg, puppies, ewes, rabbits, and chick embryos). [22, 23, 24, 25, 26] Murine studies suggest that some forms of atresia may be hereditary [emedicine.medscape.com]
Early postoperative survival rates of greater than 90% should be expected. 7 – 11 Etiology Congenital duodenal obstruction can occur due to an intrinsic or extrinsic lesion. 12 The most common cause of duodenal obstruction is atresia. 7 This intrinsic [clinicalgate.com]
[…] called also Brunner's glands. duodenal reflux retrograde movement of duodenal contents, either into the stomach where it has been incriminated as a cause of vomiting and gastric hyposecretion, or into the pancreatic duct and parenchyma as a factor in the etiology [medical-dictionary.thefreedictionary.com]
To date, none of the theories proposed offers a definitive answer to the question of the etiology of HPS. [basicmedicalkey.com]
Epidemiology
References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
The anomalies are organized by anatomical system and presented in a consistent manner, including details of the clinical presentation, epidemiology, embryology, treatment and prevention for each anomaly. [books.google.de]
After an overview of pathogenesis, classification, and epidemiology of AIDS, chapters cover early cutaneous signs and symptoms, superficial and disseminated fungal and protozoal infections, bacterial and complex infections, venereal disease, cutaneous [books.google.es]
[…] during weeks 8-10 of development Results in stenosis of the duodenal passageway between the stomach and intestinal tract leads to gastric outlet syndrome Associated with Down syndrome (20-30% of DS cases) and other birth defects as with biliary atresia Epidemiology [medbullets.com]
[…] intravenously. [1] The definitive treatment for duodenal atresia is surgery (duodenoduodenostomy), which may be performed openly or laparoscopically. [6] The surgery is not urgent. [1] The initial repair has a 5 percent morbidity and mortality rate. [2] Epidemiology [en.wikipedia.org]
Pathophysiology
Pathophysiology Duodenal atresia occurs when recanalization of the closed duodenum fails to occur or occurs only partially during the embryonic period (usually between the 8 th –10 th week of gestation). [amboss.com]
Etiology/Pathophysiology: The ratio of duodenal atresia to duodenal stenosis is 4:1. The point of atresia is distal to the ampulla of Vater in 75-80% of patients. [virtualpediatrichospital.org]
Likewise, our understanding of the etiology and pathophysiology of duodenal obstruction and malrotation has been largely stagnant. [basicmedicalkey.com]
Double duodenal atresia or stenosis is less frequently reported. [6] Pathophysiology In 1900, Tandler described the traditionally accepted theory on the normal development of the duodenum. [7] The duodenum develops from the caudal part of the foregut [emedicine.medscape.com]
Gastric outlet obstruction (GOO) represents a clinical and pathophysiological consequence of any disease process which produces mechanical impediment to gastric emptying. [tropicalgastro.com]
Prevention
The anomalies are organized by anatomical system and presented in a consistent manner, including details of the clinical presentation, epidemiology, embryology, treatment and prevention for each anomaly. [books.google.de]
A loose overbridging duodenoduodenostomy was performed to prevent compression of the vessel. The cardiac anomalies were corrected, and he could eat unrestricted diets. [ncbi.nlm.nih.gov]
and Complications Prognosis full recovery is expected after surgical correction Prevention no preventive measures are available at this time Complications without treatment, condition is lethal Please rate topic. [medbullets.com]
[…] there could be multiple diaphragms and the downstream one may be missed due to non-dilation and therefore careful passage and withdrawal of balloon Fogarty or Foley catheter both ways proximally into the stomach and distally into the small bowel will prevent [casereports.bmj.com]
Food is blocked from passing through the intestine, which prevents normal feeding and intestinal function. Intestinal atresia and stenosis usually involve the small intestine, but can affect any part of the gastrointestinal tract. [chp.edu]