Duodenal obstruction in the newborn is a not uncommon congenital anomaly, which may be caused by a variety of other congenital anomalies such as duodenal stresia stenosis, annular pancreas, or a duodenal bend with associated malrotation of the mid-gut.Duodenal atresia may be the result of an arrest in development during the 8 th to 10 th week of fetal life Duodenal stenosis is caused by a diaphragm of tissue which has a minute opening secondary to the arrested development.
Annular pancreas may be the result of failure of the normal migration of the ventral anlage of the pancreas. volvulus of the midgut due to a duodenal band or to malrotation of the colon.
Vomiting is the first and most characteristic symptom of duodenal obstruction, and the green color of the vomitus is its most important feature.
The diagnosis of duodenal obstruction can be confirmed by the X-Ray film demonstration of the ""double air bubble."" The large air bubble on the left side is due to dilation of the stomach; the smaller bubble, slightly right of the midline in the upper abdomen, represents air in the dilated duodenum.
Duodeno-jejunostomy is the operation of choice in the treatment. Both of duodenal atresia and of an annular pancreas. Ladd´s procedure should be used in cases, which have a dundenal band with associated malrotation of the gut.
In this operation the colon is separated from its abnormal attachment to the parietal peritoneum. - Then the duodenal band, responsible for the duodenal compression, can be lysed.
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