HomePhilippine Scientific Journalvol. 50 no. 1 (2017)

Double Bubble = Double Trouble: Congenital Duodenal Stenosis

Lito Jay P. Macaraig

 

Abstract:

Introduction: This case report will tackle a congenital duodenal atresia seen by ultrasound which turned out to be a duodenal stenosis intraoperatively. Case: This is a case of a 2-day-old female born to a 32-year-old G4P4 (4004) mother. On the 2nd trimester of pregnancy, she was diagnosed to have Duodenal Atresia on congenital anomaly scan (CAS). Preparations were made to deliver her in an institution with a Pediatric Surgeon on-call. On delivery, she was noted to have low-set ears, a machinery-like murmur, and widened interdigital gaps in both feet. Two-dimensional echocardiogram showed Tricuspid Regurgitation, Patent Foramen Ovale and Ductus Arteriosus. An abdominal x-ray was compatible with Duodenal Stenosis so Ladd’s procedure with appendectomy and lysis of membranous obstruction inside the duodenal lumen with duodeno-duodenostomy were done soon after delivery. Discussion/Conclusion: PA CAS allows antenatal detection of phenotypical abnormalities. This would help in formulating an appropriate treatment plan for the newborn patients requiring surgical treatment procedures. However, this should not replace pre-operative imaging and diagnostic procedures on delivery.