Abstract
The duodenum is the most common site of neonatal intestinal obstruction, accounting for 50% of all intestinal atresias. Duodenal obstruction (DO) is often complicated by prematurity and associated anomalies. Early prenatal ultrasonographic diagnosis of DO allows the mother karyotype analysis for trisomy 21 and other associated anomalies. Cardiac malformations are the major cause of morbidity and mortality in patients with congenital DO.
For most causes of congenital DOs, duodenoduodenostomy via an open approach is the preferred surgical procedure. Vidal from France and Ernst from the Netherlands are credited with the first successful repairs in 1905 and 1914, respectively. Over the last decade, the application of minimally invasive surgical techniques (MIS) and the advent of smaller laparoscopic instruments have expanded the potential of laparoscopy for repair of congenital DO. The first reported laparoscopic repairs of duodenal atresia were by Bax in 2001 and Rothenberg in 2002.
The last retrospective studies comparing the surgical outcome of laparoscopic repair versus open repair found that laparoscopy is a safe and effective technique, and the results including operative time, length of stay, time to full feeding, and complication rate were similar in both groups. The long-term survival rate of patients with DO is excellent and greater than 95% resulting from an early surgical intervention combined with advancement in neonatal intensive care, anesthesia, and nutritional support.
Keywords
Duodenum Obstruction Duodenal atresia Down syndrome Malrotation Duodenoduodenostomy Duodenal web Laparoscopy Endoscopy Associated anomaly UltrasoundNotes
Acknowledgments
This chapter has been adapted from the author’s own chapter in the following publication: Copyright © 2011 From Newborn Surgery, Third Edition, by Prem Puri. Reproduced by permission of Taylor and Francis Group, LLC, a division of Informa plc.
References
- Adams DB. Management of the intraluminal duodenal diverticulum: endoscopy or duodenotomy? Am J Surg. 1986;151(4):524–6.PubMedCrossRefPubMedCentralGoogle Scholar
- Adzick NS, Hurrison MR, deLorimier AA. Tapering duodenoplasty for megaduodenum associated with duodenal atresia. J Pediatr Surg. 1986;21:311–2.PubMedCrossRefPubMedCentralGoogle Scholar
- Akhtar J, Guiney EJ. Congenital DO. Br J Surg. 1992;79:133–5.PubMedCrossRefPubMedCentralGoogle Scholar
- Applebaum H, Lee SL, Puapong P. Duodenal atresia and stenosis-annular pancreas. In: Grosfeld JL, O’Neill JA, Fonkalsrud EW, et al., editors. Pediatric surgery. 6th ed. Philadelphia: Mosby Elsevier; 2006.Google Scholar
- Atwell JD, Klidkjian AM. Vertebral anomalies and duodenal atresia. J Pediatr Surg. 1982;17:237–40.PubMedCrossRefPubMedCentralGoogle Scholar
- Bailey PV, Tracy TF Jr, Connors RH, et al. Congenital DO; a 32 year review. J Pediatr Surg. 1993;28:92–5.PubMedCrossRefPubMedCentralGoogle Scholar
- Bax NM, Ure BM, van der Zee DC, et al. Laparoscopic duodenoduodenostomy for duodenal atresia. Surg Endosc. 2001;15(2):217.PubMedPubMedCentralCrossRefGoogle Scholar
- Beeks A, Gosche J, Giles H, et al. Endoscopic dilation and partial resection of a duodenal web in an infant. J Pediatr Gastroenterol Nutr. 2009;48(3):378–81.PubMedCrossRefPubMedCentralGoogle Scholar
- Best KE, Tennant PWG, Addor MC, et al. Epidemiology of small intestinal atresia in Europe: a regiser-based study. Arch Dis Child Fetal Neonatal Ed. 2012;97:F353–8.PubMedCrossRefPubMedCentralGoogle Scholar
- Bittencourt PFS, Malheiros RS, Ferreira AR, et al. Endoscopic treatment of congenital duodenal membrane. Gastrointest Endosc. 2012;76(6):1273–5.PubMedCrossRefPubMedCentralGoogle Scholar
- Bronshtein M, Blazer S, Zimmer EZ. The gastrointestinal tract and abdominal wall. In: Callen PW, editor. Ultrasonography in obstetrics and gynecology. 5th ed. Philadelphia: WB Saunders; 2008.Google Scholar
- Casaccia G, Bilancioni E, Nahom A, et al. Cystic anomalies of biliary tree in the fetus: it is possible to make a more specific prenatal diagnosis? J Pediatr Surg. 2002;37:1191–4.PubMedCrossRefPubMedCentralGoogle Scholar
- Choudhry MS, Rahman N, Boyd P, et al. Duodenal atresia: associated anomalies, prenatal diagnosis and outcome. Pediatr Surg Int. 2009;25:727–30.PubMedCrossRefPubMedCentralGoogle Scholar
- Chung PH, Wong CW, Ip DK, Tam PK, Wong KK. Is laparoscopic surgery better than open surgery for the repair of congenital duodenal obstruction? A review of the current evidences. J Pediatr Surg. 2017;52(3):498–503.PubMedPubMedCentralCrossRefGoogle Scholar
- Cohen-Overbeek TE, Grijseels EW, Niemeijer ND, et al. Isolated or non-isolated DO: perinatal outcome following prenatal or postnatal diagnosis. Ultrasound Obstet Gynecol. 2008;32(6):784–92.PubMedCrossRefPubMedCentralGoogle Scholar
- Dalla Vecchia LK, Grosfeld JL, West KW, et al. Intestinal atresia and stenosis: a 25-year experience with 277 cases. Arch Surg. 1998;133:490–6.PubMedCrossRefPubMedCentralGoogle Scholar
- Dankovcik R, Jirasek JE, Kucera E, et al. Prenatal diagnosis of annular pancreas: reliability of the double bubble sign with periduodenal hyperechogenic band. Fetal Diagn Ther. 2008;24:483–90.PubMedPubMedCentralCrossRefGoogle Scholar
- Dewan LA, Guiney EJ. Duodenoplasty in the management of duodenal atresia. Pediatr Surg Int. 1990;5:253–4.CrossRefGoogle Scholar
- Ein SH, Shandling B. The late nonfunctioning duodenal atresia repair. J Pediatr Surg. 1986;21:798–801.PubMedCrossRefPubMedCentralGoogle Scholar
- Ein SH, Kim PC, Miller HA. The late nonfunctioning duodenal atresia repair-a second look. J Pediatr Surg. 2000;35:690–1.PubMedCrossRefPubMedCentralGoogle Scholar
- Elliott GB, Kliman MR, Elliott KA. Pancreatic annulus: a sign or a cause of DO. Can J Surg. 1968;11:357–64.PubMedPubMedCentralGoogle Scholar
- Endo M, Ukiyama E, Yokoyama J, et al. Subtotal duodenectomy with jejunal patch for megaduodenum secondary to congenital duodenal malformation. J Pediatr Surg. 1998;33:1636–40.PubMedCrossRefPubMedCentralGoogle Scholar
- Escobar MA, Ladd AP, Grosfeld JL, et al. Duodenal atresia and stenosis: long-term follow-up over 30 years. J Pediatr Surg. 2004;39(6):867–71.PubMedCrossRefPubMedCentralGoogle Scholar
- Eustace S, Connolly B, Blake N. Congenital DO: an approach to diagnosis. Eur J Pediatr Surg. 1993;3(5):267–70.PubMedCrossRefPubMedCentralGoogle Scholar
- Gahukamble DB, Khamage AS, Shaheen AQ. Duodenal atresia: its occurrence in siblings. J Pediatr Surg. 1994;29:1599–600.PubMedCrossRefPubMedCentralGoogle Scholar
- Girvan DP, Stephens CA. Congenital intrinsic DO: a twenty-year review of its surgical management and consequences. J Pediatr Surg. 1974;9:833–9.PubMedCrossRefPubMedCentralGoogle Scholar
- Gourevitch A. Duodenal atresia in the newborn. Ann R Coll Surg Engl. 1971;48:141–58.PubMedPubMedCentralGoogle Scholar
- Grosfeld JL, Rescorla FJ. Duodenal atresia and stenosis: reassessment of treatment and outcome based on antenatal diagnosis, pathologic variants and long term follow up. World J Surg. 1993;17:301–9.PubMedCrossRefPubMedCentralGoogle Scholar
- Grosfeld JL, Ballantine TV, Shoemaker R. Operative management of intestinal atresia and stenosis based on pathologic findings. J Pediatr Surg. 1979;14:368–75.PubMedPubMedCentralCrossRefGoogle Scholar
- Gross E, Armon Y, Abudalu K, et al. Familial combined duodenal and jejunal atresia. J Pediatr Surg. 1996;31(11):1573.PubMedCrossRefGoogle Scholar
- Haeusler MC, Berghold A, Stoll C, et al. Prenatal ultrasonographic detection of gastrointestinal obstruction: results from 18 European congenital anomaly registries. Prenat Diagn. 2002;22(7):616–23.PubMedCrossRefGoogle Scholar
- Hall NJ, Drewett M, Wheeler RA, et al. Trans-anastomotic tubes reduce the need for central venous access and parenteral nutrition in infants with congenital DO. Pediatr Surg Int. 2011;27(8):851–5.PubMedCrossRefGoogle Scholar
- Hancock BJ, Wiseman NE. Congenital DO: impact of an antenatal diagnosis. J Pediatr Surg. 1989;24:1027–31.PubMedCrossRefGoogle Scholar
- Hill S, Koontz CS, Langness SM, et al. Laparoscopic versus open repair of congenital DO in infants. J Laparoendosc Adv Surg Tech. 2011;21(10):961–3.CrossRefGoogle Scholar
- Hutton KA, Thomas DF. Tapering duodenoplasty. Pediatr Surg Int. 1988;3:132–4.Google Scholar
- Irving IM. Duodenal atresia and stenosis: annular pancreas. In: Lister J, Irving IM, editors. Neonatal surgery. 3rd ed. London: Butterworths; 1990.Google Scholar
- Iuchtman M, Brereton R, Spitz L, et al. Morbidity and mortality in 46 patients with the VACTERL association. Isr J Med Sci. 1992;28:281–4.PubMedGoogle Scholar
- Iwai A, Hamada Y, Takada K, et al. Choledochal cyst associated with duodenal atresia: case report and review of the literature. Pediatr Surg Int. 2009;25:995–8.PubMedCrossRefGoogle Scholar
- Jackson CH, Yiu-Chiu VS, Smith WL, et al. Sonography of combined esophageal and duodenal atresia. J Ultrasound Med. 1983;2:473–4.PubMedCrossRefPubMedCentralGoogle Scholar
- Kanard RC, Fairbanks TJ, De Langhe SP, et al. Fibroblast growth factor-10 serves a regulatory role in duodenal development. J Pediatr Surg. 2005;40:313–6.PubMedCrossRefGoogle Scholar
- Kataria R, Bhatnagar V, Wadhwa S, et al. Gastric pneumatosis associated with preduodenal portal vein, duodenal atresia, and asplenia. Pediatr Surg Int. 1998;14(1–2):100–1.PubMedCrossRefGoogle Scholar
- Kawana T, Ikeda K, Nakagawara A, et al. A case of VACTEL syndrome with antenatally diagnosed duodenal atresia. J Pediatr Surg. 1989;24:1158–60.PubMedCrossRefGoogle Scholar
- Kay S, Yoder S, Rothenberg S. Laparoscopic duodenoduodenostomy in the neonate. J Pediatr Surg. 2009;44(5):906–8.PubMedCrossRefGoogle Scholar
- Keckler SJ, St Peter SD, Spilde TL, et al. The influence of trisomy 21 on the incidence and severity of congenital heart defects in patients with duodenal atresia. Pediatr Surg Int. 2008;24(8):921–3.PubMedCrossRefGoogle Scholar
- Kilbride H, Castor C, Andrews W. Congenital DO: timing of diagnosis during the newborn period. J Perinatol. 2010;30(3):197–200.PubMedCrossRefGoogle Scholar
- Kimble RM, Harding J, Kolbe A. Additional congenital anomalies in babies with gut atresia of stenosis: when to investigate, and which investigation. Pediatr Surg Int. 1997;12:565–70.PubMedCrossRefGoogle Scholar
- Kimura K, Tsugawa C, Ogawa K, et al. Diamond-shaped anastomosis for congenital DO. Arch Surg. 1977;112(10):1262–3.PubMedCrossRefGoogle Scholar
- Kimura K, Mukohara N, Nishijima E, et al. Diamond-shaped anastomosis for duodenal atresia: an experience with 44 patients over 15 years. J Pediatr Surg. 1990;25(9):977–9.PubMedCrossRefGoogle Scholar
- Kimura K, Perdzynski W, Soper RT. Elliptical seromuscular resection for tapering the proximal dilated bowel in duodenal or jejunal atresia. J Pediatr Surg. 1996;31:1405–6.PubMedCrossRefGoogle Scholar
- Knechtle SJ, Filston HC. Anomalous biliary ducts associated with duodenal atresia. J Pediatr Surg. 1990;25(12):1266–9.PubMedCrossRefGoogle Scholar
- Kokkonen ML, Kalima T, Jaaskelainen J, et al. Duodenal atresia: late follow-up. J Pediatr Surg. 1998;23:216–20.CrossRefGoogle Scholar
- Komuro H, Ono K, Hoshino N, et al. Bile duct duplication as a cause of distal bowel gas in neonatal DO. J Pediatr Surg. 2011;46(12):2301–4.PubMedCrossRefGoogle Scholar
- Kouwenberg M, Kapusta L, van der Staak FH, et al. Preduodenal portal vein and malrotation: what causes the obstruction? Eur J Pediatr Surg. 2008;18:153–5.PubMedCrossRefGoogle Scholar
- Lambrecht W, Kluth D. Hereditary multiple atresias of the gastrointestinal tract: report of a case and review of the literature. J Pediatr Surg. 1998;33:794–7.PubMedCrossRefGoogle Scholar
- Lauw JH, Barnard CN. Congenital intestinal atresia: observations on its origin. Lancet. 1955;2:1065–7.CrossRefGoogle Scholar
- Lawrence MJ, Ford WDA, Furness ME, et al. Congenital DO: early antenatal ultrasound diagnosis. Pediatr Surg Int. 2000;16:342–5.PubMedCrossRefGoogle Scholar
- Malone FD, Crmbleholme TM, Nores JA, et al. Pitfalls of the ‘double bubble’ sign: a case of congenital duodenal duplication. Fetal Diagn Ther. 1997;12:298–300.PubMedCrossRefGoogle Scholar
- Markljung E, Adamovic T, Ortqvist L, et al. A rare microduplication in a familial case of annular pancreas and duodenal stenosis. J Pediatr Surg. 2012;47:2039–43.PubMedCrossRefGoogle Scholar
- Melek M, Edirne YE. Two cases of DO due to a congenital web. World J Gastroenterol. 2008;14(8):1305–7.PubMedPubMedCentralCrossRefGoogle Scholar
- Mentessidou A, Saxena AK. Laparoscopic repair of duodenal atresia: systematic review and meta-analysis. World J Surg. 2017;41(8):2178–84.PubMedCrossRefGoogle Scholar
- Merrot T, Anastasescu R, Pankevych T, et al. Duodenal duplications. Clinical characteristics, embryological hypotheses, histological findings, treatment. Eur J Pediatr Surg. 2006;16:18–23.PubMedCrossRefGoogle Scholar
- Mikaelsson C, Arnbjörnsson E, Kullendorff CM. Membranous duodenal stenosis. Acta Paediatr. 1997;86(9):953–5.PubMedCrossRefGoogle Scholar
- Moore SW, de Jongh G, Bouic P, et al. Immune deficiency in familial duodenal atresia. J Pediatr Surg. 1996;31:1733–5.PubMedCrossRefGoogle Scholar
- Mordehai J, Cohen Z, Kurzbart E, et al. Preduodenal portal vein causing DO associated with situs inversus, intestinal malrotation, and polysplenia: a case report. J Pediatr Surg. 2002;37(4):E5.PubMedCrossRefGoogle Scholar
- Morikawa N, Kuroda T, Honna T, et al. A novel association of duodenal atresia, malrotation, segmental dilatation of the colon, and anorectal malformation. Pediatr Surg Int. 2009;25:1003–5.PubMedCrossRefGoogle Scholar
- Muraji T, Mahour GH. Surgical problems in patients with VATER-associated anomalies. J Pediatr Surg. 1984;19:550–4.PubMedCrossRefGoogle Scholar
- Murshed R, Nicholls G, Spitz L. Intrinsic DO: trends in management over 45 years (1951–1995) with relevance to prenatal counselling. Br J Obstet Gynaecol. 1999;106:1197–9.PubMedCrossRefGoogle Scholar
- Nawaz A, Matta H, Hamchou M, et al. Situs inversusabdominus in association with congenital DO: a report of two cases and review of the literature. Pediatr Surg Int. 2005;21:589–92.PubMedCrossRefGoogle Scholar
- Nixon HH. An experimental study of propulsion in isolate small intestine and applications to surgery in the newborn. Ann R Coll Surg Engl. 1960;27:105–24.PubMedPubMedCentralGoogle Scholar
- Norton K, Tenreiro R, Rabinowitz JG. Sonographic demonstration of annular pancreas and a distal duodenal diaphragm in a newborn. Pediatr Radiol. 1992;22:66–7.PubMedCrossRefGoogle Scholar
- Oh C, Lee S, Lee SK, Seo JM. Laparoscopic duodenoduodenostomy with parallel anastomosis for duodenal atresia. Surg Endosc. 2017;31(6):2406–10.PubMedCrossRefGoogle Scholar
- Okamatsu T, Arai K, Yatsuzuka M, et al. Endoscopic membranectomy for congenital duodenal stenosis in an infant. J Pediatr Surg. 1989;24(4):367–8.PubMedCrossRefGoogle Scholar
- Okti PH, Holland AJA, Pitkin J. Double bubble, double trouble. Pediatr Surg Int. 2005;21:428–31.CrossRefGoogle Scholar
- Pameijer CR, Hubbard AM, Coleman B, et al. Combined pure esophageal atresia, duodenal atresia, biliary atresia and pancreatic ductal atresia: prenatal diagnostic features and review of the literature. J Pediatr Surg. 2000;35:745–7.PubMedCrossRefGoogle Scholar
- Papandreou E, Baltogiannis N, Cigliano B, et al. Annular pancreas combined with distal stenosis. A report of four cases and review of the literature. Pediatr Med Chir. 2004;26(4):256–9.PubMedGoogle Scholar
- Piper HG, Alesbury J, Waterford SD, et al. Intestinal atresia: factors affecting clinical outcomes. J Pediatr Surg. 2008;43(7):1244–8.PubMedCrossRefGoogle Scholar
- Pulkkinen L, Kimonis VE, Xu Y, et al. Homozygous alpha6 integrin mutation in junctional epidermolysis bullosa with congenital duodenal atresia. Hum Mol Genet. 1997;6:669–74.PubMedCrossRefGoogle Scholar
- Puri P. Outlook after surgery for congenital intrinsic DO in down syndrome. Lancet. 1981;2(8250):802.PubMedCrossRefGoogle Scholar
- Ramalho-Santos M, Melton DA, McMahon AP. Hedgehog signals regulate multiple aspects of gastrointestinal development. Development. 2000;127(12):2763–72.PubMedGoogle Scholar
- Rattan KN, Singh J, Dalal P. Neonatal duodenal obstruction: a 15-year experience. J Neonatal Surg. 2016;5(2):13.PubMedPubMedCentralGoogle Scholar
- Reid LS. Biliary tract abnormalities associated with duodenal atresia. Arch Dis Child. 1973;48:952–7.PubMedPubMedCentralCrossRefGoogle Scholar
- Romero R. Duodenal atresia. In: Romero R, Pilu G, Jeanty P, et al., editors. Prenatal diagnosis of congenital anomalies. Norwalk: Appleton and Lange; 1988.Google Scholar
- Rothenberg SS. Laparoscopic duodenoduodenostomy for DO in infants and children. J Pediatr Surg. 2002;37(7):1088–9.PubMedCrossRefPubMedCentralGoogle Scholar
- Rowe M, Buckner D, Clatworthy HW Jr. Wind sock web of the duodenum. Am J Surg. 1968;116:444–9.PubMedCrossRefPubMedCentralGoogle Scholar
- Sadler T. Langman’s medical embryology. Baltimore: Lippincott Williams and Wilkins; 2003.Google Scholar
- Salonen IS, Makinen E. Intestinal blind pouch – and blind loop – syndrome in children operated previously for congenital DO. Ann Chir Gynaecol. 1976;65:38–45.PubMedPubMedCentralGoogle Scholar
- Samuel M, Wheeler RA, Mami AG. Does duodenal atresia and stenosis prevent midgut volvulus in malrotation? Eur J Pediatr Surg. 1997;7(1):11–2.PubMedCrossRefPubMedCentralGoogle Scholar
- Singal AK, Ramu C, Paul S, et al. Preduodenal portal vein in association with midgut malrotation and duodenal web-triple anomaly. J Pediatr Surg. 2009;44(2):5–7.CrossRefGoogle Scholar
- Singh MV, Richards C, Bowen JC. Does down syndrome affect the outcome of congenital DO? Pediatr Surg Int. 2004;20(8):586–9.PubMedCrossRefPubMedCentralGoogle Scholar
- Skandalakis JE, Gray SW. Embryology for surgeons: the embryological basis for the treatment of congenital anomalies. Baltimore: Williams & Wilkins; 1994.Google Scholar
- Son TN, Kien HH. Laparoscopic versus open surgery in management of congenital duodenal obstruction in neonates: a single-center experience with 112 cases. J Pediatr Surg. 2017;52(12):1949–51.PubMedCrossRefPubMedCentralGoogle Scholar
- Spigland N, Yazbeck S. Complications associated with surgical treatment of congenital intrinsic DO. J Pediatr Surg. 1990;25(11):1127–30.PubMedCrossRefPubMedCentralGoogle Scholar
- Spilde TL, St Peter SD, Keckler SJ, et al. Open vs laparoscopic repair of congenital DOs: a concurrent series. J Pediatr Surg. 2008;43(6):1002–5.PubMedCrossRefPubMedCentralGoogle Scholar
- Spitz L, Ali M, Brereton RJ. Combined esophageal and duodenal atresia: experience of 18 patients. J Pediatr Surg. 1981;16:4–7.PubMedCrossRefPubMedCentralGoogle Scholar
- Srivastava P, Shaikh M, Mirza B, Jaiman R, Arshad M. Preduodenal portal vein associated with duodenal obstruction of other etiology: a case series. J Neonatal Surg. 2016;5(4):54.PubMedPubMedCentralCrossRefGoogle Scholar
- Sugimoto T, Yamagiwa I, Obata K, et al. Choledochal cyst and duodenal atresia: a rare combination of malformations. Pediatr Surg Int. 2004;20(9):724–6.PubMedCrossRefPubMedCentralGoogle Scholar
- Sweed Y. Duodenal obstruction. In: Puri P, Höllwarth M, editors. Pediatric surgery atlas series. Berlin: Springer; 2006.Google Scholar
- Sweed Y. Duodenal obstruction. In: Puri P, Hollwarth M, editors. Pediatric surgery: diagnosis & management. Berlin: Springer; 2009.Google Scholar
- Sweed Y. Duodenal obstruction. In: Puri P, editor. Newborn surgery. 3rd ed. Boca Raton: CRC Press; 2011.Google Scholar
- Sweed Y, Bar-Maor JA, Shoshany G. Insertion of a soft silastic nasogastric tube at operation for esophageal atresia: a new technical method. J Pediatr Surg. 1992;27(5):650–1.PubMedCrossRefPubMedCentralGoogle Scholar
- Tandler J. Zur Entwicklungsgeschichte des menschlichen duodenums in fruhen Embryonalstadiun. Morphol Jahrb. 1900;29:187–216.Google Scholar
- Teague WJ, Jones MLM, Hawkey L, et al. FGF10 and the mystery of duodenal atresia in humans. Front Genet. 2018;9:530.PubMedPubMedCentralCrossRefGoogle Scholar
- Torfs CP, Christianson RE. Anomalies in down syndrome individuals in a large population-based registry. Am J Med Genet. 1998;77:431–8.PubMedCrossRefPubMedCentralGoogle Scholar
- Tsukerman GL, Krapiva GA, Krillova IA. First-trimester diagnosis of duodenal stenosis associated with oesophageal atresia. Prenat Diagn. 1993;13:371–6.PubMedCrossRefPubMedCentralGoogle Scholar
- Upadhyay V, Sakalkale R, Parashar K, et al. Duodenal atresia: a comparison of three modes of treatment. Eur J Pediatr Surg. 1996;6(2):75–7.PubMedCrossRefPubMedCentralGoogle Scholar
- Valusek PA, Spilde TL, Tsao K, St Peter SD, Holcomb GW 3rd, Ostlie DJ. Laparoscopic duodenal atresia repair using surgical U-clips: a novel technique. Surg Endosc. 2007;21(6):1023–4.PubMedCrossRefPubMedCentralGoogle Scholar
- van Rijn RR, van Lienden KP, Fortuna TL, et al. Membranous duodenal stenosis: initial experience with balloon dilatation in four children. Eur J Radiol. 2006;59(1):29–32.PubMedCrossRefPubMedCentralGoogle Scholar
- Vaos G, Misiakos EP. Congenital anomalies of the gastrointestinal tract diagnosed in adulthood – diagnosis and management. J Gastrointest Surg. 2010;14(5):916–25.PubMedCrossRefPubMedCentralGoogle Scholar
- Weber TR, Smith W, Grosfeld JL. Surgical experience in infants with the VATER association. J Pediatr Surg. 1980;15:849–54.PubMedCrossRefPubMedCentralGoogle Scholar
- Weber TR, Lewis JE, Mooney D, et al. Duodenal atresia: a comparison of techniques of repair. J Pediatr Surg. 1986;21(12):1133–6.PubMedCrossRefGoogle Scholar
- Weisgerber G, Boureau M. Immediate and secondary results of duodeno-duodenostomies with tapering in the treatment of total congenital DOs in newborn infants. Chir Pediatr. 1982;23:369–72.PubMedGoogle Scholar
- Wesley JR, Mahour GH. Congenital intrinsic duodenal obstruction: a twenty-five year review. Surgery. 1977;82(5):716–20.PubMedGoogle Scholar
- Young DG, Wilkinson AW. Abnormalities associated with neonatal DO. Surgery. 1968;63:832–6.PubMedGoogle Scholar
- Young JS, Goco I, Pennell T. Duodenoplasty and reimplantation of the ampulla of Vater for megaduodenum. Am J Surg. 1993;59:685–8.Google Scholar
- Zani A, Yeh JB, King SK, Chiu PP, Wales PW. Duodeno-duodenostomy or duodeno-jejunostomy for duodenal atresia: is one repair better than the other? Pediatr Surg Int. 2017;33(2):245–8.PubMedCrossRefGoogle Scholar
- Zimmer EZ, Bronstein M. Early diagnosis of duodenal atresia and possible sonographic pitfalls. Prenat Diagn. 1996;16:564–6.PubMedCrossRefGoogle Scholar