Duodenal atresia is a condition in which the duodenum (the first part of the small bowel) has not developed properly. It is not open and cannot allow the passage of stomach contents.

Causes, incidence, and risk factors

The cause of duodenal atresia is unknown but it is thought that damage to the duodenum from a loss of blood supply during gestation causes the duodenum to narrow and become obstructed. Duodenal atresia is present in approximately 1 out of 6,000 newborns. There is an increased association of duodenal atresia with Downs syndrome. Approximately 25% of duodenal atresia is found in infants with Downs. Infants born with duodenal atresia begin vomiting large amounts of material shortly after birth. The vomitus may be green ( bile stained) and the volume often is greater than that which is fed to the infant. One or two initial meconium stools may be passed but no others. Untreated, these infants dehydrate and become critically ill very rapidly. Suggestion of duodenal atresia may be seen on routine ultrasound studies of the fetus. Suspected atresia may be diagnosed after birth with an X-ray . Surgery to fix the duodenum is then performed. Following surgery, infants may have significant feeding and absorption problems.

Signs and tests

Treatment

Surgery to remove the blocked section of duodenum is necessary. The patient receives a general anesthetic. An incision is made in the abdomen. The abnormal segment of duodenum is removed, and the remaining ends of the bowel are reconnected. Associated problems (such as Downs syndrome) must be treated as appropriate.

Expectations (prognosis)

Recovery from the duodenal atresia is expected after treatment. There may be persistent feeding problems, absorption problems, and increased vitamin requirements ( vitamin B12 ) following surgery, but this is unusual. Untreated, the condition is fatal.

Complications

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