Journal of Yeungnam Medical Science

Original Articles

Clinical Study of Congenital Duodenal Obstruction.: Young Soo Huh, Myeung Kook Lim, Sung Kyu Park; Yeungnam Univ J Med. 1998;15(1):67-74. Published online June 30, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.1.67

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Abstract PDF: Successful management of duodenal obstruction in newborn infant implies not only satisfactory nutrition but also achivement of normal growth. To aid early diagnosis and management, we evaluated the diagnostic methods, operative interventions and clinical characteristics of thirty-nine infants with congenital duodenal obstructions. In the 11-year period from July 1986 through June 1997, thirty-nine patients with congenital duodenal obstruction (23 males and 16 females) were treated and reviewed at the Department of Pediatric Surgery, Yeungnam University Hospital. The ratio of male to female was 1.4:1, and 29 cases(74.1%) among total 39 patients were newborn. There were 5 premature patients and 16 patients of small for gestational age. The most common causes of the congenital duodenal obstruction was malrotation (26 cases, 66.7%) and followed by annular pancreas (9 cases, 23.1%), type 1 atresia (3 cases, 7.7%) and wind-sock anomaly (1 case, 2.6%). Common symptoms were vomiting, abdominal distention, jaundice. Plain abdominal X-ray study combined with upper gastrointestinal series was the most commonly used diagnostic method. The operative procedures were performed by same pediatric surgeon utilizing Ladd's procedure in 26, duodenoduodenostomy in 8, duodenojejunostomy in 4, excision of wind-sock membrane in 1. A total of 15 associated congenital anomalies were found in 9 patients. Postoperative complications occurred in 13 (33.3%). Overall mortality was 2.6%(1/39). Bilious vomiting and plain abdominal radiologic study were most useful for the diagnosis of congenital duodenal obstruction. Early diagnosis and operative intervention were important to prevent complications such as sepsis and peritonitis.

A Clinical Study of Congenital Duodenal Obstruction.: Young Soo Huh, Bo Yang Suh, Koing Bo Kwun; Yeungnam Univ J Med. 1990;7(2):39-48. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.39

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Abstract PDF: Congenital duodenal obstruction in the newborn infant may be due to a variety of causes. Duodenal obstruction often presents with bilious vomiting and upper abdominal distention. Diagnosis is usually established on plain x-ray of the abdomen by the classic finding of the double-bubble. In the period July 1986 to June 1990, 16 patients with congenital duodenal obstruction were operated and the following results were obtained. 1. Sixteen patients were comprised of 11 males and 5 females, the ratio of male and female was 2.2:1. 2. Thirteen patients (81%) had been admitted to our hospital during one month of life. 3. Congenital duodenal obstruction was in 16 cases; malrotation in eight (50%), annular pancreas in six (38%), type 1 atresia in one (6%), and wind-sock anomaly in one (6%). 4. There were two premature patients and six patients of small for gestational age. 5. Overall, bilious vomiting, occurring in three fourths, was the single most frequent presenting complaint. 6. Polyhydramnios occurred in two of the patients. 7. Diagnosis was possible with clinical symptom and simple abdomen. 8. The operative procedures performed were; duodenoduodenostomy in five, duodenojejunostomy in two, excision of wind-sock membrane in one, and Ladd's procedure in eight. 9. A total of ten associated congenital anomalies were found in six patients. 10. Postoperative complications occurred in five cases (31%).

Case Report

Preduodenal Portal Vein Associated with Duodenal Obstruction: A case report.: Young Soo Huh, Jae Hwang Kim, Bo Yang Suh, Koing Bo Kwun; Yeungnam Univ J Med. 1990;7(1):211-214. Published online June 30, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.1.211

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Abstract PDF: Portal vein anomalies include absence, duplication, and malposition (preduodenal portal vein). Duplication of the portal vein or a preduodenal portal vein are hazards at the time of biliary or duodenal surgery, or liver transplantation. Preduodenal portal vein, which was first reported by knight in 1921, is extremely rare congenital anomaly and may cause duodenal obstruction. Recently, we experienced a case of preduodenal portal vein associated with dextrocardia, situs inversus, and duodenal obstruction in a 3 days old male newborn and report with review of the references.

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