• Risk factors and their influence on the surgical results of congenital duodenal obstruction in infants

Risk factors and their influence on the surgical results of congenital duodenal obstruction in infants

SOVREMENNAYA PEDIATRIYA.2017.4(84):134-138; doi 10.15574/SP.2017.84.134

Sliepov O., Migur M., Juravel A.
SI «Institute of Pediatrics, Obstetrics and Gynecology NAMS Ukraine», Kyiv

Rationale. According to the current literature, the factors affecting mortality among infants with congenital duodenal obstruction (CDO) remain underinvestigated.

Objective: to investigate the risk factors and their impact on the results of CDO surgical treatment in newborns.

Materials and methods. A retrospective analysis of medical records of 34 infants with CDO and autopsy protocols of children who died after surgery was conducted. To study the influence of various factors on mortality among these infants, all patients were divided into two groups. Children with CDO who recovered after surgical treatment were enrolled in the 1st group (n=26). In the 2nd group infants with CDO who died after surgery (n=8) were included.

Results. According to the study, the impact of prenatal diagnosis, delivery in the perinatal center, term of gestation at the moment of childbirth, age at the time of primary surgery and surgical postoperative complications on mortality was statistically invalid in terms of infant mortality (P>0.05). Weight of child at birth, sepsis, respiratory and cardiovascular failure, had a statistically significant effect on mortality in newborns with CDO (P<0.05).

Conclusions. Child's weight at birth, sepsis, respiratory and cardiovascular failure are the factors that influence on the outcomes in newborns with CDO.

Key words: congenital duodenal obstruction, risk factors, newborns.


1. Ameh EA, Nmadu PT. (2000). Intestinal atresia and stenosis: a retrospective analysis of presentation, morbidity and mortality in Zaria, Nigeria. West African Journal of Medicine. 19(1): 39—42. PMid:10821085

2. Holcomb III GW, Murphy JP, Ostlie DJ. (2014). Ashcraft's Pediatric Surgery. 6th Ed. Philadelphia, Еlsevier saunders: 1040.

3. Kaddah SN, Bahaa-Aldin KHK, Aly HF, Hassan HS. (2006). Congenital duodenal obstruction. Ann Pediatr Surg. 2(2): 130—135.

4. Qing-Jiang Chen, Zhi-Gang Gao, Jin-Fa Tou et al. (2014). Congenital duodenal obstruction in neonates: a decade's experience from one center. World J Pediatr. 10(3): 238—244. https://doi.org/10.1007/s12519-014-0499-4; PMid:25124975

5. Bittencourt DG, Barini R, Marba S, Sbragia L. (2004). Congenital duodenal obstruction: does prenatal diagnosis improve the outcome? Pediatr Surg Int. 20(8): 582—5. Epub 2004 Aug 25. https://doi.org/10.1007/s00383-004-1235-2; PMid:15338169

6. Escobar MA, Ladd AP, Grosfeld JL et al. (2004). Duodenal atresia and stenosis: long-term follow-up over 30 years. Pediatr Surg. 39(6): 867—871. https://doi.org/10.1016/j.jpedsurg.2004.02.025

7. Niramis R, Anuntkosol M, Tongsin A, Mahatharadol V. (2010). Influence of Down's syndrome on management and outcome of patients with congenital intrinsic duodenal obstruction. J Pediatr Surg. 45(7): 1467—1472. https://doi.org/10.1016/j.jpedsurg.2010.02.049; PMid:20638526

8. Dalla Vecchia LK, Grosfeld JL, West KW et al. (1998). Intestinal atresia and stenosis: a 25-year experience with 277 cases. Arch Surg. 133(5): 490—6; discussion 496—7. https://doi.org/10.1001/archsurg.133.5.490; PMid:9605910

9. Slіepov O, Migur M, Soroka V. (2016). Associated Malformations and Mortality in Newborns with Congenital Small-Bowel Obstruction. GALICIAN MEDICAL JOURNAL. 23; 3. https://doi.org/10.21802/gmj.2016.3.20

10. Savran B, Adiguzel U, Yuksel KB et al. (2016). The importance of antenatal diagnosis of congenital duodenal obstruction. Ir J Med Sci. 185(3): 695—8. https://doi.org/10.1007/s11845-015-1345-y. Epub 2015 Jul 28.

11. Hall NJ, Drewett M, Wheeler RA et al. (2011). Trans-anastomotic tubes reduce the need for central venous access and parenteral nutrition in infants with congenital duodenal obstruction. Pediatr Surg Int. 27(8): 851—855. https://doi.org/10.1007/s00383-011-2896-2; PMid:21476073