[Duodenal atresia and stenosis].

Background: Analysis of results of surgical treatment of congenital duodenal obstruction at authors' institution.

Methods And Results: Retrospective analysis of demographic and clinical data collected from hospital and outpatient documentation. Age at operation, sex, type of duodenal obstruction, associated anomalies, type of operation, time of parenteral nutrition, onset of enteral nutrition, early and late complications were recorded and analyzed. Between January 1991 and December 2006, 77 patients (female to male ration 1.6:1) with duodenal obstruction were operated on. Among them there were 48 patients with duodenal atresia, 20 with duodenal membrane and 9 with annular pancreas. The average age at operation for duodenal atresia was 2.15 days, most patients (33 i.e. 43%) were operated on the 1st day of life. The average age at operation for duodenal membrane and annular pancreas was 7, 35 and 5, 8 days. In 33 patients diamond duodenoduodenoanastomosis (Kimuraes procedure) was performed, excision of membrane was the second most frequent operation (22 times). We noted complications in 38 patients, the most common one was sepsis (14 cases) followed by gastroesophageal reflux (6 times). The mortality in our group was 9,1%--7 infants. One death only was caused by a surgical complication--anastomotic leakage. The period of follow-up was 5 months to 16 years.

Conclusions: Congenital duodenal obstruction has, with appropriate surgical treatment, a good long and short-term prognosis. Ninety to 95% of patients survive without significant sequellae. The mortality is low and is caused by associated malformations, the principal cause of death is sepsis.