Esophageal duodenal atresia abnormalities of hands
Overview
Fonkalsrud reviewed 503 cases of congenital duodenal obstruction treated between 1957 and 1967.1 Of patients who were surgically treated, 64% survived. Deaths were attributed to associated malformations, respiratory complications, prematurity, and anastomotic complications. More recent survival rates for infants born with duodenal atresia or stenosis are approximately 90-95%.2, 3 Increased survival rates can be attributed to advances in respiratory care, hyperalimentation, improved pediatric anesthesia, improvements in the recognition and management of associated anomalies, and more refined surgical techniques (eg, the diamond-shaped anastomosis4).
Symptoms
Symptoms of upper intestinal obstruction commence within the first 24 hours after birth. However, patients may present hours or days after delivery. Sustained vomiting (bilious or nonbilious) is the most common symptom, occurring in approximately 85% of cases.2, 1, 3 Nonbilious vomiting occurs when atresia is present above the papilla of Vater. Vomiting is associated with variable dehydration, changes in serum electrolytes, and weight loss.
Causes
An infant with a gastric aspirate that measures greater than 30 mL in the delivery room or newborn nursery should be evaluated for duodenal atresia and other causes of upper intestinal obstruction