Duodenal atresia is a condition in which the first part of the small bowel the duodenum has not developed properly. It is not open and cannot allow the passage of stomach contents. The cause of duodenal atresia is not known. It is thought to result from problems during an embryo's development. The duodenum does not change from a solid to a tube-like structure, as it normally would.
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If you're coming to GOSH, please remember that hospital visitors are limited to one carer per family. This must be the same carer each day. Unfortunately, siblings will not be able to visit the hospital.
In line with the latest national advice, we are now testing all inpatients for COVID, as well as offering testing to the parent or carer who accompanies them. While we understand that these measures will be difficult for families, our priority is the safety of all GOSH patients, families and staff. This stops food and fluid passing from the stomach into the intestines. Duodenal atresia can sometimes be discovered during pregnancy as it often shows up on antenatal ultrasound scanning.
Some babies with this condition are born prematurely. Many babies appear well at birth but when they start to feed, they are sick and their vomit may be green.
An X-ray scan can confirm this diagnosis. Duodenal atresia is a rare condition and occurs in about one in 6, births. It can be associated with other problems, so the doctors will examine a child closely to check if this is the case. Duodenal atresia is repaired in an operation under general anaesthetic which lasts around 90 minutes. The operation to repair the duodenal atresia can either be carried out using open surgery or sometimes using laparoscopic keyhole surgery. The baby will be transferred to the hospital soon after birth.
This will drain off the contents of the stomach and stop the child feeling and being sick. It also releases any excess air from the stomach, which could make the child uncomfortable.
They will also have an intravenous infusion drip of fluids and medicines. The surgeon will explain about the operation in more detail, discuss any worries families may have and ask them to sign a consent form giving permission for the child to have the operation.
An anaesthetist will also visit to explain about the anaesthetic. The surgeon will open the blind end of the duodenum and connect it to the rest of the intestine. All surgery carries a small risk of bleeding during or after the operation. During the operation, the surgeon will minimise any bleeding by sealing off the blood vessels affected.
There is a very small chance that nearby structures in the abdomen could be damaged during surgery, but this is a very rare occurrence. There is a chance that the area where the two ends of bowel were joined could start to leak, allowing bowel contents to escape into the abdomen.
This is usually treated with antibiotics, but a second operation may be needed to check the leaking portion. Every anaesthetic carries a risk of complications, but this is very small.
The anaesthetist is a very experienced doctor who is trained to deal with any complications. There are two ways of carrying out the operation: using laparoscopic keyhole surgery or open surgery.
The surgeon will discuss the most appropriate method. There is a small possibility that having started the procedure using laparoscopic surgery, it will not be possible to repair the atresia using this method. The surgeon will then change to use open surgery during the same operation. It can take a while after the operation for the bowel to start working properly, so the child may need to be fed intravenously using total parenteral nutrition TPN for a while.
This affects many children and is explained further in the next section. The baby will come back to recover either on the intensive care unit or our surgical ward.
All babies are closely monitored after the operation, and so the baby will be connected to monitors to check their breathing, heart rate and oxygen levels. If the child needs help with breathing, they will be nursed on the intensive care unit and connected to a ventilator. They will also be given pain relief through the intravenous infusion drip.
This is called total parenteral nutrition or TPN. This will gradually be replaced by breast or bottled milk, given through the nasogastric tube when the child is able to tolerate this.
As the baby recovers, they will be able to feed from the breast or bottle. Over time, the drips and monitors will be removed one by one. The nurses on the ward will encourage families to look after their baby as much as they feel able while the child is recovering. This can be daunting, especially while the baby is connected to drips and monitors, but it will become easier with time.
If anyone is worried about caring for their baby, they can talk to the nurses. The child will be able to go home or be transferred back to a local hospital once they are feeding properly and gaining weight.
Most children stay in hospital for one to two weeks, but occasionally a longer stay is needed. A local health visitor or community paediatric nurse will visit regularly. If the duodenal atresia occurs on its own with no other associated problems, the outlook is very good, with the majority of children growing up to live normal lives.
The outlook for children with duodenal atresia and other conditions varies, depending on how severe the other problems are.
Some children who have had duodenal atresia develop a problem with gastrooesophageal reflux when they are older. This is where the contents of their stomach flow back up the oesophagus gullet causing pain and irritation. There is no support group for those with for duodenal atresia, but the following organisations may be able to help:.
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How is duodenal atresia diagnosed? How is it treated? Are there any alternatives? No - duodenal atresia always requires treatment to allow a baby to feed. What happens before the operation?
What does the operation involve? Are there any risks? What happens afterwards? We send details of any outpatient appointments in the post, soon after they leave hospital. What is the outlook for children with duodenal atresia? Compiled by:. Last review date:. August Disclaimer Please note this is a generic GOSH information sheet so should not be used for the diagnosis or treatment of any medical condition.
If you have specific questions about how this relates to your child, please ask your doctor. More information There is no support group for those with for duodenal atresia, but the following organisations may be able to help: BLISS - Helpline: or website: www.
It is considered to be one of the commonest causes of a fetal bowel obstruction. Patients present in early life with duodenal obstruction and associated symptoms of abdominal distension, vomiting and absent bowel movements. In complete atresia, duodenum ends blindly with no communication with the distal bowel and therefore no aeration distally. If the atresia is proximal to the ampulla, the vomiting is non-bilious. Recognition that these structures are not continuous with the stomach will aid in the correct interpretation.
Duodenal atresia is the congenital absence or complete closure of a portion of the lumen of the duodenum. It causes increased levels of amniotic fluid during pregnancy polyhydramnios and intestinal obstruction in newborn babies. Radiography shows a distended stomach and distended duodenum, which are separated by the pyloric valve, a finding described as the double-bubble sign. Treatment includes suctioning out any fluid that is trapped in the stomach, providing fluids intravenously, and surgical repair of the intestinal closure.
If you're coming to GOSH, please remember that hospital visitors are limited to one carer per family. This must be the same carer each day. Unfortunately, siblings will not be able to visit the hospital. In line with the latest national advice, we are now testing all inpatients for COVID, as well as offering testing to the parent or carer who accompanies them. While we understand that these measures will be difficult for families, our priority is the safety of all GOSH patients, families and staff. This stops food and fluid passing from the stomach into the intestines.