J Med Assoc Thai 2001; 84 (6):842

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Surgical Treatment for Congenital Duodenal Obstruction
Ruangtrakool R Mail, Laohapensang M , Mungnirandr A , Sathornkich C

Thirty-four congenital duodenal obstructions (19 duodenal atresia, 7 duodenal web, 7 annular
pancreas and one duodenal stenosis) were surgically treated in Siriraj Hospital between 1990 and
1999. Eleven per cent of duodenal atresia had no bile-stained vomiting. Duodenal web which received
web excision and duodenoplasty in 43 per cent of cases, also presented with bile-stained vomiting.
Duodeno-duodenostomy, duodeno-jejunostomy and web excision with duodenoplasty were performed
in 29, 2 and 3 patients respectively. Duodeno-duodenostomy and web excision with duodenoplasty
had no difference in the feeding capability. There was no statistically significant difference in dura-
tion of TPN, ability to be early fed, post-operative onset of full feeding and hospital stay between
diamond-shaped (n
=
18) and side-to-side (n
=
11) duodeno-duodenostomy. Although transanas-
tomotic feeding tube (n
=
4) decreased a percentage of TPN requirement and made early feeding
possible, the onset of full feeding, duration of TPN and hospital stay were not different from those
who had no transanastomotic tube (n
=
30).
Key word : Duodenal Obstruction, Duodenal Atresia, Pancreas, Suture Techniques, Anastomosis,
Postoperative Complications, Treatment Outcome, Child, Infant, Newborn

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