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]
Abstract We present a case of incomplete duodenal obstruction having a delayed presentation, making diagnosis and early intervention more challenging. [afrjpaedsurg.org]
Entire Body System
- Juvenile Cataract
It is primarily a clinical diagnosis with manifestations that include poikiloderma, short stature, sparse hair, juvenile cataracts, small hands and feet, bone defects, photosensitivity, hypogonadism, defective dentition, onychodystrophy, and hyperkeratosis [ncbi.nlm.nih.gov]
- Soft Tissue Mass
Abdominal CT scan revealed the periaortic soft tissue mass encircling grafted aorta and stenosis of duodenal third portion. Retroperitoneal fibrosis with duodenal stenosis was diagnosed and prednisolone therapy was initiated. [ncbi.nlm.nih.gov]
Gastrointestinal
- Vomiting
DISCUSSION Duodenal stenosis frequently presents with recurrent vomiting and failure to thrive. Owing to its chronic and variable presentation, the diagnosis is often delayed. [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]
Preampullary lesions with non-bilious vomiting simulating gastric outlet obstruction has been reported recently [1]. [jpss.eu]
- Bilious Vomiting
Preampullary lesions with non-bilious vomiting simulating gastric outlet obstruction has been reported recently [1]. [jpss.eu]
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]
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]
[…] 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]
Abdominal distention with bilious vomiting is observed within the first 24 hours after birth. [aafp.org]
- 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]
- Recurrent Vomiting
Most patients are diagnosed during the neonatal period based on recurrent vomiting, but some cases develop symptoms at an older age. [ncbi.nlm.nih.gov]
Case Report A 10-month-old male infant presented to pediatric emergency department with history of recurrent vomiting and failure to thrive. His height and weight was below third percentile for his age. [file.scirp.org]
Duodenal stenting was suggested when recurrent vomiting was observed in the absence of features suggestive of peritoneal carcinomatosis, and was confirmed using imaging methods. [spandidos-publications.com]
Succussion splash, demonstrated by auscultation of a “splash” reflective of retained gastric material, if noted more than four hours after a meal is suggestive of GOO with a sensitivity of 50%. [23 ] Investigations Patients with recurrent vomiting may [tropicalgastro.com]
- Dyspepsia
2016 2017 2018 2019 Billable/Specific Code Type 1 Excludes dyspepsia NOS ( R10.13 ) heartburn ( R12 ) nervous dyspepsia ( F45.8 ) neurotic dyspepsia ( F45.8 ) psychogenic dyspepsia ( F45.8 ) catarrhal K31.89 Inertia stomach K31.89 Insufficiency, insufficient [icd10data.com]
Skin
- Sparse Hair
It is primarily a clinical diagnosis with manifestations that include poikiloderma, short stature, sparse hair, juvenile cataracts, small hands and feet, bone defects, photosensitivity, hypogonadism, defective dentition, onychodystrophy, and hyperkeratosis [ncbi.nlm.nih.gov]
- Sparse Hair
It is primarily a clinical diagnosis with manifestations that include poikiloderma, short stature, sparse hair, juvenile cataracts, small hands and feet, bone defects, photosensitivity, hypogonadism, defective dentition, onychodystrophy, and hyperkeratosis [ncbi.nlm.nih.gov]
- Lanugo
71 Although jejunoileal atresias are usually not hereditary, there is a well-documented autosomal recessive pattern of inheritance of multiple atresias. 72 In these cases, intestinal rotation was normal, mesenteric defects were never observed, and lanugo [clinicalgate.com]
Musculoskeletal
- Small Hand
It is primarily a clinical diagnosis with manifestations that include poikiloderma, short stature, sparse hair, juvenile cataracts, small hands and feet, bone defects, photosensitivity, hypogonadism, defective dentition, onychodystrophy, and hyperkeratosis [ncbi.nlm.nih.gov]
Ears
- Low Set Ears
Clinical examination revealed microcephaly, hypotelorism, microphthalmia, a flat rudimentary nose with a single nasal cavity, high palate, thick dysplastic low-set ears, a short neck, postaxial polydactyly of the upper limbs, and single palmar creases [ncbi.nlm.nih.gov]
Neurologic
- Spastic Quadriplegia
Our results suggest that congenital duodenal stenosis/atresia is a potential risk factor for spastic quadriplegia in patients with Down syndrome. [ncbi.nlm.nih.gov]
- Quadriplegia
Our results suggest that congenital duodenal stenosis/atresia is a potential risk factor for spastic quadriplegia in patients with Down syndrome. [ncbi.nlm.nih.gov]
Workup
The diagnostic preoperative workup should include a plain abdominal radiograph, upper and/or lower gastrointestinal contrast studies, and ultrasonography (1). [journals.lww.com]
Other Pathologies
- Multilocular Cyst
It appeared as an irregularly shaped, multilocular cyst with no contrast effect. Abdominal magnetic resonance imaging (MRI) showed low mass intensity on T1-weighted images and high intensity on T2-weighted images ( Fig. 2 A and B). [ncbi.nlm.nih.gov]
Biopsy
- Foam Cell
small lymphatic spaces, abundant lymphoid tissue, and smooth muscle, and foam cells are present containing lipoid material in varying amounts. 5 Such masses are also called hamartomas. 1,7 Our patient's tumor was classified as a cystic lymphangioma. [ncbi.nlm.nih.gov]
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]
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]
With surgical correction, prognosis is excellent (especially with isolated cases), and the outlook is therefore largely determined by other associated abnormalities. [radiopaedia.org]
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]
Etiology
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]
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]
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]
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]
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]
[…] 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]