The outcome of congenital duodenal obstruction in infancy in Erbil


  • Karzan K. Hussein Department of Pediatric Surgery, Rapareen Teaching Hospital, Erbil, Iraq
  • Nooraddin Ismaeel A. Department of General Surgery, College of Medicine, Hawler Medical University, Erbil, Iraq
  • Salar S. Perdawd Department of Pediatric Surgery, College of Medicine, Hawler Medical University, Erbil, Iraq



Congenital duodenal obstruction, Infants, Erbil


Background and objective: Duodenal atresia and stenosis is considered a frequent cause of intestinal obstruction in the newborn, good prenatal work up and investigation make early diagnosis and better prognosis. This study aimed to evaluate the prenatal diagnosis, types, post-delivery management, associated anomalies, operative management and outcomes in neonates with congenital duodenal obstruction.

Methods: A prospective study including 21 infants (13 female and eight male) with congenital duodenal obstruction were treated at Rapareen Teaching Hospital in Erbil from December 2011 to December 2015.

Results: The mean age at presentation was 8.1 days (range 4 to 52 days), and the mean weight was 2.63 kilogram. Around 95% were term and 61.9% of patients delivered through cesarean section. The commonest presentation was bilious vomiting in 95.2% of cases. Associated anomalies were present in six cases in particular Down’s syndrome in five cases. Plain abdominal x-ray, ultrasound of abdomen and echocardiography done for all cases while upper gastrointestinal contrast study was done only in 5 cases. All managed operatively through laparotomy, and diamond shaped duodenoduodenostomy was the main procedure done in 17 cases, web resection in two cases, Ladd's procedure in one case and duodenojejunostomy in one case. The survival was 95.2%.

Conclusion: Congenital duodenal obstruction is a common condition facing the pediatric surgeon. Associated anomalies is the first factor influencing the outcome. The most common causes of congenital duodenal obstruction were atresia, and annular pancreas and the most important warning sign is the bile stained vomiting. Treatment should be expedient and concurrent with ongoing resuscitation.


Metrics Loading ...


Nixon HH, Tawes R. Etiology and treatment of small intestinal atresia. Surgery 1971: 69:41–51.

Schnauffer L. Duodenal atresia, stenosis and annular pancreas. In: Welch KJ, Randolph JG, Ravitch MM (eds). Pediatric surgery, 4th ed. Chicago: Book Medical; 1991. P. 829–37.

Calkins CM, Karrer F, Deodhar J. Duodenal Atresia. E Medicine Word Medical Library, 2003.4.

Alastair JW, Heinz Rod M, Cywes S. Intestinal Atresia And Stenosis: Pediatric Surgery, 4th ed. by Elsevier Inc., 2005; 416–34.

Aguayo P, Ostlie DJ. Duodenal and intestinal atresia and stenosis, London; New York: Saunders/Elsevier; 2014. P. 415.

Enochsson L, Runold M, Fenyo G . Contrast radiography in small intestinal obstruction, a valuable diagnostic tool. Eur J Surg 2001; 167(2):120–4.

Pathak D, Sarin YK. Congenital duodenal obstruction due to a preduodenal portal vein. Indian J Pediatr 2006; 73(5):423–5.

Upadhyay V, Sakalkale R, Parashar K, Mitra SK, Buick RG, Gornall P, et al . Duodenal atresia: a comparison of three modes of treatment. Eur J Pediatr Surg 1996; 6:75–7.

Bowen J, Dickson A, Bruce J. Reconstruction for duodenal atresia. J Pediatr Surg 1996; 11:474.

Gavopoulos S, Lima CH, Avtzoglou P. Operative and postoperative management of congenital duodenal obstruction. Pediatr SurgInt 1993; 8:122–4.

Weaver E . Operative Management of duodenal atresia. Pediatr Surg Int 1995;10:332.

Kimura K, Mukahara N, Nishijima E. Diamond shaped anastamosis for duodenal atresia. Pediatr Surg 1996; 25:977.

Qing-Jiang Chen, Zhi-Gang Gao. Congenital duodenal obstruction in neonates: a decade's experience from one center, World J Pediatr 2014; 10(3):238–44.

Tsai LY, Hsieh WS, Chen CY, Chou HC, Tsao PN, Hsu WM. Distinct clinical characteristics of patients with congenital duodenal obstruction in a medical center in Taiwan. Pediatr Neonatol 2010; 51(6):343-6.

Zamir N, Akhtar J. Neonatal duodenal obstruction: Clinical presentation and outcome. Pakistan J Surgery 2013; 18(4):182–5.

Bailey PV, Tracy TF Jr, Connors RH, Mooney DP, Lewis JE, Weber TR. Congenital duodenal obstruction: a 32-years review. J Pediatric Surg 1993; 28(1):92–5.

Irving IM, Rickham PP. Duodenal atresia and stenosis; annular pancreas. In: Rickham PP, Lister J, Irving IM (eds). Neonatal surgery, 2nd ed. Boston: Butterworth; 1990. P. 355–70.

Al-Salem AH. Congenital intrinsic duodenal obstruction: a review of 35 cases. Saudi Med 2007; 27(4):289–92.

Sweed Y. Duodenal obstruction. In: Puri P (ed) Newborn surgery. Arnold. London: CRC Press 2003. P. 423–33.

Kaddah SN, Bahaa-Aldin HK, Fayad Aly H, Hassan HS. Congenital duodenal obstruction. Ann Pediatr Surg 2006; 2(2):130–5.

Apple BH, Lee SL, Puapong DP. Duodenal atresia and stenosis - annular pancreas. In: Grosfeld, O'Neill, Fonkalsrud, and Coran. Pediatric Surgery. Philadelphia, PA: Mosby Elsevier; 2006. P.1260–8.




How to Cite

Hussein, K. K., A., N. I., & Perdawd, S. S. (2018). The outcome of congenital duodenal obstruction in infancy in Erbil. Zanco Journal of Medical Sciences (Zanco J Med Sci), 22(2), 257–261.



Original Articles