correct answer
E Observation
Duodenal atresia is a common cause of newborn intestinal obstruction occurring in more than one in ten thousand births. Associated congenital anomalies include trisomy 21, cardiac anomalies and Hirschsprung disease. Long term follow-up of these patients show that most patients are asymptomatic following repair. Endoscopic and radiologic findings have found that duodenal dilation may persist years after the procedure even in patients without symptoms. It should be noted that there is a poor correlation between symptoms and radiologic and/or endoscopic findings. The megaduodenum may fail to return to normal caliber and duodenogastric reflux and duodenal dysmotility may persist decades after the initial surgery in asymptomatic patients. Therefore, symptoms should dictate whether follow-up studies or surgery is required.
Up to 12% may develop late complications such as duodenal stasis or poor motility in the dilated segment. Some of these patients may require anterior or lateral duodenal plication. Less than ten percent require revision of the anastomosis.
E Observation
Duodenal atresia is a common cause of newborn intestinal obstruction occurring in more than one in ten thousand births. Associated congenital anomalies include trisomy 21, cardiac anomalies and Hirschsprung disease. Long term follow-up of these patients show that most patients are asymptomatic following repair. Endoscopic and radiologic findings have found that duodenal dilation may persist years after the procedure even in patients without symptoms. It should be noted that there is a poor correlation between symptoms and radiologic and/or endoscopic findings. The megaduodenum may fail to return to normal caliber and duodenogastric reflux and duodenal dysmotility may persist decades after the initial surgery in asymptomatic patients. Therefore, symptoms should dictate whether follow-up studies or surgery is required.
Up to 12% may develop late complications such as duodenal stasis or poor motility in the dilated segment. Some of these patients may require anterior or lateral duodenal plication. Less than ten percent require revision of the anastomosis.
Comment