Duodenal obstruction in neonates: Diagnosis and treatment

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor II Tran Van Trong - Specialist in Pediatric Surgery, Plastic Surgery - Aesthetics - Department of General Surgery, Vinmec Danang International Hospital

Duodenal obstruction is one of the common causes of neonatal intestinal obstruction. This condition can be accompanied by other diseases such as congenital heart disease, Down syndrome, esophageal atrophy... The disease can pose serious risks if not diagnosed and treated early. Therefore, if the baby shows signs of poor feeding, abdominal distension, fussiness, vomiting after feeding... it is necessary to take the child to the doctor immediately.

1. What is duodenal obstruction in infants?

Duodenal obstruction is a condition that occurs when part of the duodenum does not form. This condition leads to a blockage that prevents food (milk) or liquid from the stomach from going down normally.
Congenital duodenal obstruction is a rare disease. This can be a single malformation but can sometimes be associated with other malformations, which are common in infants with Down syndrome. About 1 in 3 babies born with duodenal obstruction have Down syndrome. In addition, congenital duodenal obstruction often has a high rate with a number of other malformations such as congenital heart disease, esophageal atrophy, urinary tract anomalies...

2. Diagnosis of duodenal obstruction in infants

Prenatal diagnosis of duodenal obstruction is increasingly common, can be detected as early as 18-20 weeks of pregnancy, especially in women with polyhydramnios.
Ultrasound leading to a diagnosis usually occurs through one of two situations:
If genetic screening or diagnostic testing identifies a child at risk for Down syndrome: ultrasound will be performed to screen duodenal obstruction. In the case of a pregnancy without the risk of Down syndrome, ultrasound will be used to visualize the uterus during the third trimester. An enlarged uterus is sometimes caused by too much amniotic fluid, which is polyhydramnios.

3. Treatment of duodenal obstruction in infants

Newborns with duodenal obstruction can be delivered vaginally and require specialist medical care after birth. Most infants with duodenal obstruction are able to breathe on their own, but they will not be able to suckle or drink from a bottle and will instead be fed nutrients through the bloodstream. When your baby's intestines are blocked, a flexible tube will be inserted into the stomach through the nose or mouth. This tube will be used to suck up any air or liquid that has built up in the child's stomach.
Treatment of duodenal obstruction in infants requires surgery to remove the obstruction and repair the duodenum. However, surgery is not considered an emergency, usually done when the baby is resuscitated and well prepared for surgery - then the baby is about 2 or 3 days old. The surgeon will remove the two obturator ends of the blocked intestine, then insert a catheter from the child's mouth through the stomach, through the anastomosis (enteric anastomosis) into the lumen of the small intestine below, and then suture the bowel to restore it. Restore gastrointestinal circulation. This catheter will be used for the first 1-2 weeks after surgery to help with early post-operative feeding.

Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.