Duodenal Atresia

Definition

Definition of Duodenal Atresia
Duodenal atresia is the congenital absence or complete closure of a portion of the lumen of the duodenum.

Symptoms

Symptoms of Duodenal Atresia

1. Upper abdominal swelling may or may not be present
2. Early vomiting of large amounts, which may be greenish (containing bile)
3. Continued vomiting even when infant has not been fed for several hours
4. Absent urination after first few voidings
5. Absent bowel movements after first few meconium stools

Causes

Causes of Duodenal Atresia
The cause of duodenal atresia is unknown, but it is thought to result from problems during an embryo's development in which the duodenum does not normally change from a solid to a tube-like structure.

Duodenal atresia is seen in more than 1 in 10,000 live births. Approximately 20-30% of infants with duodenal atresia have Down syndrome. Duodenal atresia is often associated with other birth defects.

Diagnosis

Diagnosis of Duodenal Atresia
The diagnosis of duodenal atresia is usually confirmed by radiography. An X-ray of the abdomen shows two large air filled spaces, the so-called "double bubble" sign. The air is trapped in the stomach and proximal duodenum. Since the closure of the duodenum is complete in duodenal atresia, no air is seen in the distal duodenum.

Treatment

Treatment of Duodenal Atresia
The only treatment for duodenal atresia is surgery, which is usually done shortly after birth. Prior to surgery, a nasogastric (NG) tube will be placed in the baby’s stomach to drain the excess fluid and air that have accumulated, and the baby will get an IV so that he can receive fluids that will prevent dehydration. Your pediatrician and surgeon will discuss your baby’s prognosis and care plan with you prior to surgery.

Infants with other birth defects or other underlying conditions may not do as well as infants that only have duodenal atresia. Most infants do extremely well after surgery and completely recover from this birth defect.

Prognosis

Prognosis of Duodenal Atresia
Recovery from the duodenal atresia is expected after treatment. Untreated, the condition is deadly.

Prevention

Prevention of Duodenal Atresia
There is no known prevention.