Duodenal atresia surgery: Difference between revisions
Jump to navigation
Jump to search
Hamid Qazi (talk | contribs) |
Hamid Qazi (talk | contribs) |
||
| Line 19: | Line 19: | ||
==Surgery== | ==Surgery== | ||
[[Surgery]] is the mainstay of treatment for duodenal atresia.<ref name="FreemanTorfs2009">{{cite journal|last1=Freeman|first1=SB|last2=Torfs|first2=CP|last3=Romitti|first3=PA|last4=Royle|first4=MH|last5=Druschel|first5=C|last6=Hobbs|first6=CA|last7=Sherman|first7=SL|title=Congenital gastrointestinal defects in Down syndrome: a report from the Atlanta and National Down Syndrome Projects|journal=Clinical Genetics|volume=75|issue=2|year=2009|pages=180–184|issn=00099163|doi=10.1111/j.1399-0004.2008.01110.x}}</ref><ref name="KayYoder2009">{{cite journal|last1=Kay|first1=Saundra|last2=Yoder|first2=Suzanne|last3=Rothenberg|first3=Steve|title=Laparoscopic duodenoduodenostomy in the neonate|journal=Journal of Pediatric Surgery|volume=44|issue=5|year=2009|pages=906–908|issn=00223468|doi=10.1016/j.jpedsurg.2009.01.025}}</ref> | [[Surgery]] is the mainstay of treatment for duodenal atresia.<ref name="FreemanTorfs2009">{{cite journal|last1=Freeman|first1=SB|last2=Torfs|first2=CP|last3=Romitti|first3=PA|last4=Royle|first4=MH|last5=Druschel|first5=C|last6=Hobbs|first6=CA|last7=Sherman|first7=SL|title=Congenital gastrointestinal defects in Down syndrome: a report from the Atlanta and National Down Syndrome Projects|journal=Clinical Genetics|volume=75|issue=2|year=2009|pages=180–184|issn=00099163|doi=10.1111/j.1399-0004.2008.01110.x}}</ref><ref name="KayYoder2009">{{cite journal|last1=Kay|first1=Saundra|last2=Yoder|first2=Suzanne|last3=Rothenberg|first3=Steve|title=Laparoscopic duodenoduodenostomy in the neonate|journal=Journal of Pediatric Surgery|volume=44|issue=5|year=2009|pages=906–908|issn=00223468|doi=10.1016/j.jpedsurg.2009.01.025}}</ref><ref name="MorrisKennedy2016">{{cite journal|last1=Morris|first1=Grant|last2=Kennedy|first2=Alfred|last3=Cochran|first3=William|title=Small Bowel Congenital Anomalies: a Review and Update|journal=Current Gastroenterology Reports|volume=18|issue=4|year=2016|issn=1522-8037|doi=10.1007/s11894-016-0490-4}}</ref> | ||
*[[Laparotomy]] or [[Laparoscopic surgery|laparoscopy]] can be performed. | *[[Laparotomy]] or [[Laparoscopic surgery|laparoscopy]] can be performed. | ||
Revision as of 19:09, 2 January 2018
|
Duodenal Atresia Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Duodenal atresia surgery On the Web |
|
American Roentgen Ray Society Images of Duodenal atresia surgery |
|
Risk calculators and risk factors for Duodenal atresia surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]
| https://www.youtube.com/watch?v=xxfAEwmVPbk%7C350}} |
Overview
Surgery is the mainstay of treatment for duodenal atresia. A nasogastric or orogastric tube should be inserted to decompress the abdomen. A laparotomy or laparoscopy can be performed to correct duodenal atresia. Surgical procedures include duodenoduodenostomy, and duodenojejunostomy.
Indications
Surgery is the first-line treatment option for patients with duodenal atresia. [1]
- Ultrasound shows duodenal obstruction
- Abdominal x-ray shows air fluid levels
Surgery
Surgery is the mainstay of treatment for duodenal atresia.[1][2][3]
- Laparotomy or laparoscopy can be performed.
- A nasogastric or orogastric tube should be inserted to decompress the abdomen.
Surgical procedures include:
- Side-to-side duodenoduodenostomy
- Bypass procedure
- Diamond-shaped anastomosis is constructed between the proximal transverse to the distal longitudinal anastomosis
- End-to-side duodenoduodenostomy
- Bypass procedure
- Diamond-shaped anastomosis is constructed between the proximal transverse to the distal longitudinal anastomosis
- Duodenojejunostomy
Post Operative Care
- Orogastric tube is left in place for drainage
- Oral feedings not given until
- bowel sounds are heard
- stool is passed
- Gastric drainage is limited (<1 mL/kg/hr of clear or pale-green fluid).
- Give total parenteral nutrition (TPN)
Preparation for surgery
- Orogastric decompression of the stomach
- Fluid resuscitation
- Broad-spectrum antibiotics
- 1 mg vitamin K
Post Surgical Complications
The post surgical complications of duodenal atresia are as follows:[4][5][6]
- Post surgical complications include:
- Adhesions
- Blind loop syndrome
- Duodenal dysmotility
- Megaduodenum with blind loop syndrome
- Duodenogastric reflux and gastritis
- Peptic ulcer disease
- Gastroesophageal reflux
- Cholelithiasis
- Cholecystitis
Contraindications
There are no contraindications to surgical repair of duodenal atresia.
References
- ↑ 1.0 1.1 Freeman, SB; Torfs, CP; Romitti, PA; Royle, MH; Druschel, C; Hobbs, CA; Sherman, SL (2009). "Congenital gastrointestinal defects in Down syndrome: a report from the Atlanta and National Down Syndrome Projects". Clinical Genetics. 75 (2): 180–184. doi:10.1111/j.1399-0004.2008.01110.x. ISSN 0009-9163.
- ↑ Kay, Saundra; Yoder, Suzanne; Rothenberg, Steve (2009). "Laparoscopic duodenoduodenostomy in the neonate". Journal of Pediatric Surgery. 44 (5): 906–908. doi:10.1016/j.jpedsurg.2009.01.025. ISSN 0022-3468.
- ↑ Morris, Grant; Kennedy, Alfred; Cochran, William (2016). "Small Bowel Congenital Anomalies: a Review and Update". Current Gastroenterology Reports. 18 (4). doi:10.1007/s11894-016-0490-4. ISSN 1522-8037.
- ↑ Spigland N, Yazbeck S (1990). "Complications associated with surgical treatment of congenital intrinsic duodenal obstruction". J Pediatr Surg. 25 (11): 1127–30. PMID 2273425.
- ↑ Kokkonen ML, Kalima T, Jääskeläinen J, Louhimo I (1988). "Duodenal atresia: late follow-up". J Pediatr Surg. 23 (3): 216–20. PMID 3357136.
- ↑ Bishay, M.; Lakshminarayanan, B.; Arnaud, A.; Garriboli, M.; Cross, K. M.; Curry, J. I.; Drake, D.; Kiely, E. M.; De Coppi, P.; Pierro, A.; Eaton, S. (2012). "The role of parenteral nutrition following surgery for duodenal atresia or stenosis". Pediatric Surgery International. 29 (2): 191–195. doi:10.1007/s00383-012-3200-9. ISSN 0179-0358.