We describe three cases of duodenal stenosis due to periduodenal hematoma with similar clinical courses. Duodenal atresia has been reported in association with various malformations and syndromes common being down syndrome, malrotation, and annular pancreas. Pdf duodenal atresia with major duodenal papilla within. Atlas of fetal duodenal atresia by mri, beth israel deaconess medical center duodenal atresia sonography of this 35 week fetus demonstrates the double bubble sign characteristic of duodenal atresia as well as polyhydramnios. Chapter 62 duodenal atresia and stenosis felicitas eckoldtwolke afua a. Paraduodenal pancreatitis is a distinct clinicopathological entity involving the duodenum and the pancreatic tissue in the vicinity of the minor papilla. This duodenal mucosa is present in the stomach and duodenum that have fingerlike structure. Duodenal stenosis due to periduodenal hematoma is a rare condition. We present a case of spontaneous intramural duodenal hematoma and a case of. Isolated duodenal perforation idp in pediatric trauma is rarely reported. The diagnosis characteristic of the duodenitis was examined.
These three types are known as the transitionaltype duodenal mucosa, duodenal mucosa and jejunatype duodenal mucosa. Duodenal atresia is an embryopathy of the cranial intestine that leads to a complete absence of the duodenal lumen. Check related conditions for additional relevant tests. Prenatal ultrasonography makes possible an early diagnosis and treatment with better survival. The price is significantly lower at surgery centers in mexico, where the level of patient care and safety standards are rising.
Although clinical presentations should vary among causes, symptoms of duodenal stenosis due to periduodenal hematoma commonly include abdominal pain, nausea, or vomiting. Duodenal atresia with major duodenal papilla within duodenal atretic segment. Duodenal atresia is a condition commonly identified in new born infants as it a congenital disorder. We report a case of idp and emphasize on certain specific clinical features indicating possibility of duodenal injury. Ccap volumen 9 numero 1 45 wilson daza paula agudelo esperanza paez silvana dadan s. Herein 3 cases of duodenal atresia associated with multiple congenital anomalies are being reported. These patients often have prolonged duodenal ileus. The studies show that the three different types of the mucosa differ with each other on the basis of their susceptibility. At surgery 7085% of gastrinomas are found in the right upper quadrant duodenal and pancreatic head area, the socalled gastrinoma triangle 4, 5. In 3052% of infants it is an isolated anomaly, but it is often associated with. It causes increased levels of amniotic fluid during pregnancy polyhydramnios and intestinal obstruction in newborn babies. Its association with multiple anomalies is rare and scarcely reported in literature.
An isolated duodenal perforation in pediatric blunt. Intestinal atresia is the main cause of obstruction in the digestive tract in newborn. The children came from a population of approximately 100,000 children over a 10year period. Most smallbowel adenocarcinomas arise from the duodenum or proximal small bowel, and close attention. Susana gonzalez gurrola abril, 2017 atresia intestinal 2. One of the three different types of duodenal mucosa, a transitional type, is also known. Gastrinoma duodenal and pancreatic neuroendocrinology 2006. Imaging of groove pancreatitis duodenal adenocarcinoma these tumors can be quite difficult to differentiate from groove pancreatitis, especial ly when they present as focal thickening of the medial duodenal wall. Anatomic factors such as duodenal retroperitoneal fixation, position in front of the vertebral column, the rich submucosal and subserosal vascular plexus, and a weak muscular abdominal wall, are all contributory to the development of idh. Malformaciones congenitas digestivas pediatria integral. Duodenal atresia is the congenital absence or complete closure of a portion of the lumen of the duodenum due to the defective fusion of foregut and midgut with failure of the recanalisation. Duodenal atresia is the congenital absence or complete closure of a portion of the lumen of the duodenum.
In 2540% of cases, the anomaly is encountered in an infant with trisomy 21 down syndrome. As soon as the baby takes the first few feeds, there is visible distention of the stomach and as there is duodenal atresia complete or partial the food regurgitates back into the stomach and the esophagus causing. In more than half of the patients with duodenal atresia, associated anomalies and syndromes are present. O duodeno pode ser obstruido por estenose, atresia e por pressao. An isolated duodenal perforation in pediatric blunt abdominal. Multidisciplinary management of patients with esophageal atresia. Atresia esofagica y duodenal by sandra carolina monroy. A congenital malformation characterized by the absence of a normal opening in a part of the duodenum.
The typical presentation is bilious vomiting within the first hour of birth. A characteristic finding of duodenal obstruction is the doublebubble image of an airfilled stomach proximal to an airfilled first portion of the duodenum. The duodenal mucosa suffers from the small and inveterate duodenal ulcers. Obstruccion duodenal en pacientes pediatricos medigraphic. This appears to mildly displace the adjacent head of pancreas and superior mesenteric vein and mildly compress the underlying inferior vena cava. Congenital duodenal obstruction, a common complication of down syndrome, most often presents as neonatal bilious vomiting. Intrinsic duodenal obstruction may be caused by duodenal atresia, stenosis, diaphragm with or without perforation, or by a windsock. Since most of the children with blunt trauma are managed expectantly, timely diagnosis is imperative to avoid morbidity and mortality. The overall mortality was 32%, although it fell from 39% in the. Radiography shows a distended stomach and distended duodenum, which are separated by the pyloric valve, a finding described as the doublebubble sign. Obstrucao duodenal etiologia, patofisiologia, sintomas, sinais, diagnostico e prognostico. Duodenal hematoma is a rare complication of endoscopic duodenal biopsy that occurs mainly in children or adults with impaired coagulation.
Duodenal hematoma following endoscopic duodenal biopsy. A case report article pdf available in journal of pediatric surgery case reports 25 may 2014 with 36 reads. Sep 09, 20 therapy operation surgical correction of duodenal obstruction is not urgent prior to the mid 1970s, duodenojejunostomy was the preferred technique for correcting duodenal atresia or stenosis various techniques. Strict radiological and clinical criteria were observed in making this diagnosis. Multidisciplinary management of patients with esophageal. One hundred and twentyeight of 3 41% patients with duodenal injuries underwent the procedure, with a duodenal fistula rate of 5. However the pathogenesis of the condition and its relationship with acute pancreatitis remain unknown.
Evaluation and management of traumatic liver, pancreas, and splenic injuries in children are discussed separately. Down syndrome is present in 30% of cases, malrotation in 20%, and congenital heart diseases in 20% of cases. Gastric and duodenal ulcers cannot be differentiated based on history alone, although some findings may be suggestive. The incidence of duodenal atresia is between 110,000 and 16,000 live births, with an approximately equal male to female ratio. Epigastric pain is the most common symptom of both gastric and duodenal ulcers and is characterized by a gnawing or burning sensation occurring shortly after meals with gastric ulcer and 23 hours afterward with duodenal ulcer. Duodenal atresia is a comparative emergency but time should be spent in evaluation, stabilization, and rehydration. We also stress upon the role of early contrastenhanced. Duodenal switch ds cost comparison mexico bariatric. Puede estar afectado cualquier sitio del tubo digestivo, su localizacion mas frecuente es yeyuno e ileon. Relatively speaking, congenital duodenal atresia is one of the more common intestinal anomalies treated by pediatric surgeons, occurring 1 in 25005000 live births. Gastroduodenal definition of gastroduodenal by medical.
Aug 09, 2016 when duodenal atresia is suspected, erect and recumbent plain radiography of the abdomen should be the first imaging study obtained. Hesse sanjay krishnaswami introduction congenital duodenal obstruction may be due to intrinsic or extrinsic lesions. Duodenal atresia genetic and rare diseases information. Is computed tomography a useful adjunct to the clinical examination for the diagnosis of pediatric gastrointestinal perforation from blunt abdominal trauma in children. Fortynine cases of duodenal ulcer in children are presented. Duodenal atresia is the congenital absence or complete closure of a portion. There are three different types of histological duodenal mucosa are present in normal human body. Most afflicted patients are young alcoholic males who present clinically with upper abdominal pain, weight loss, nausea, and vomiting.