Duodenal Atresia

Definition: A condition in which the duodenum (the first part of the small bowel) has not developed properly; it is not open and cannot allow the passage of stomach contents. 

Causes, incidence, and risk factors:  The cause of duodenal atresia is unknown but it is thought that damage to the duodenum, such as loss of blood supply during gestation causes the duodenum to lose tissue, narrow, and become obstructed. Duodenal atresia is present in approximately 1 out of 6,000 newborns. There is an increased association of duodenal atresia with Downs syndrome. Approximately 25% of duodenal atresia is found in infants with Downs. 

 Infants born with duodenal atresia begin vomiting large amounts of material shortly after birth. The vomitus may be green (bile stained) and the volume often is greater than that which is fed to the infant. One or two initial meconium stools may be passed but no others. Untreated, these infants dehydrate and become critically ill very rapidly.  Suggestion of duodenal atresia may be seen on routine ultrasound studies of the fetus. Suspected atresia may be diagnosed after birth with an X-ray. Surgery to fix of the duodenum is then performed.

Symptoms: Following surgery, infants may have significant feeding and absorption problems. 

  • abnormal fetal ultrasound 
  • early vomiting of large amounts 
  • green vomiting (bile) 
  • continued vomiting even when infant has not been fed for several hours 
  • absent urination after first few voidings 
  • absent bowel movements after first few meconium stools 

Signs and tests: Suggestive pregnancy ultrasound (if done), polyhydramnios (excessive amounts of amniotic fluid in the uterus), abdominal X-ray, blood chemistries (to check blood electrolytes) 

Other signs: excessive amniotic fluid (polyhydramnios). Downs syndrome is present in a quarter of cases of duodenal atresia 

Treatment: Surgery to remove the blocked section of duodenum is necessary. Associated problems (such as Downs syndrome) must be treated as appropriate. 

Expectations (prognosis): Recovery from the duodenal atresia is expected after treatment. There may be persistent feeding problems, absorption problems, and increased vitamin requirements (vitamin B12) following surgery. Untreated, the condition is fatal. 

Complications: associated congenital anomalies, dehydration. 

As with any procedure we perform, your child's safety and well-being our #1 priority.  As always, feel free to contact us with any question that you have.  We would be happy to answer it for you.