The late nonfunctioning duodenal atresia repair - A second look

Background/Purpose: In 1986, the authors reported on 3 newborns who had rep air of their duodenal atresia, and between 6 and 18 months postoperatively an anastomotic obstruction developed in each suddenly. After prolonged medi cal and surgical treatments it became apparent that the duodenal atresia re pair was functionally obstructed and plication of the dilated atonic proxim al duodenum was curative. Since then, 2 more patients became so obstructed at 5 and 24 years postoperatively. The aim of this study was to report the very late occurrence of a functional obstruction of a newborn duodenal atre sia repair. Methods: The 2 additional histories and surgical repairs were reviewed. Results: The 5-year old boy was cured immediately with plication only of hi s dilated proximal duodenum. The 24-year-old nurse had a very stormy 2-year course with several bypass operations, which did not relieve her abdominal pain and bile vomiting until they were taken down and her dilated proximal duodenum was plicated, after which she made a good recovery. Both remain w all. Conclusion: An uncommon, very late, sudden, apparently anastomotic, postope rative, newborn, duodenal atresia repair obstruction caused by proximal, di lated, duodenal atony, and dysfunction can occur many years later and respo nds to duodenal plication alone. Copyright (C) 2000 by W.B. Saunders Compan y.