Congenital duodenal obstruction in the UK: a population-based study
Open Access
- 22 June 2019
- journal article
- research article
- Published by BMJ in Archives of Disease in Childhood: Fetal & Neonatal
- Vol. 105 (2), 178-183
- https://doi.org/10.1136/archdischild-2019-317085
Abstract
Objective Congenital duodenal obstruction (CDO) comprising duodenal atresia or stenosis is a rare congenital anomaly requiring surgical correction in early life. Identification of variation in surgical and postoperative practice in previous studies has been limited by small sample sizes. This study aimed to prospectively estimate the incidence of CDO in the UK, and report current management strategies and short-term outcomes. Design Prospective population-based, observational study for 12 months from March 2016. Setting Specialist neonatal surgical units in the UK. Main outcome measures Incidence of CDO, associated anomalies and short-term outcomes. Results In total, 110 cases were identified and data forms were returned for 103 infants giving an estimated incidence of 1.22 cases per 10 000 (95% CI 1.01 to 1.49) live births. Overall, 59% of cases were suspected antenatally and associated anomalies were seen in 69%. Operative repair was carried out mostly by duodenoduodenostomy (76%) followed by duodenojejunostomy (15%). Postoperative feeding practice varied with 42% having a trans-anastomotic tube placed and 88% receiving parenteral nutrition. Re-operation rate related to the initial procedure was 3% within 28 days. Two infants died within 28 days of operation from unrelated causes. Conclusion This population-based study of CDO has shown that the majority of infants have associated anomalies. There is variation in postoperative feeding strategies which represent opportunities to explore the effects of these on outcome and potentially standardise approach. Short-term outcomes are generally good.Keywords
Funding Information
- National Institute for Health Research, Academic Clinical Fellow - George Bethell
- National Institute for Health Research Professorship award - Marian Knight
This publication has 19 references indexed in Scilit:
- Transanastomotic tubes reduce the cost of nutritional support in neonates with congenital duodenal obstructionPediatric Surgery International, 2018
- Is laparoscopic surgery better than open surgery for the repair of congenital duodenal obstruction? A review of the current evidencesJournal of Pediatric Surgery, 2017
- Congenital duodenal obstruction in neonates: a decade’s experience from one centerWorld Journal of Pediatrics, 2014
- A Modern Cohort of Duodenal Obstruction Patients: Predictors of Delayed Transition to Full Enteral NutritionJournal of Nutrition and Metabolism, 2014
- Epidemiology of small intestinal atresia in Europe: a register-based studyArchives of Disease in Childhood: Fetal & Neonatal, 2012
- Laparoscopic Repair of Duodenal Atresia: RevisitedWorld Journal of Surgery, 2011
- Duodenal atresia: associated anomalies, prenatal diagnosis and outcomePediatric Surgery International, 2009
- Small intestinal atresia in a defined population: occurrence, prenatal diagnosis and survivalPrenatal Diagnosis, 2007
- Duodenal atresia and stenosis: long-term follow-up over 30 yearsJournal of Pediatric Surgery, 2004
- Prenatal ultrasonographic detection of gastrointestinal obstruction: results from 18 European congenital anomaly registriesPrenatal Diagnosis, 2002