Congenital duodenal obstruction in the UK: a population-based study. Issue 2 (22nd June 2019)

• Record Type: Journal Article
• Authors: Bethell, George Stephen; Long, Anna-May; Knight, Marian; Hall, Nigel J
• Other Names: author non-byline.; Jones Abigail author non-byline.; Aslam Adil author non-byline.; Mortell Alan author non-byline.; Mccabe Amanda author non-byline.; Ross Andrew author non-byline.; Harris Anna author non-byline.; Lawson Anne author non-byline.; Kelay Arun author non-byline.; Abhyankar Aruna author non-byline.; Rajimwale Ashok author non-byline.; Saeed Atif author non-byline.; Eradi Bala author non-byline.; Sharif Baqer author non-byline.; Maccormack Brian author non-byline.; Pardy Caroline author non-byline.; Ridd Catherine author non-byline.; Jones Ceri author non-byline.; Jones Ceri author non-byline.; Driver Chris author non-byline.; Parsons Chris author non-byline.; Kwok Chun-sui author non-byline.; Rees Clare author non-byline.; Skerritt Clare author non-byline.; Aronson Dan author non-byline.; Marshall David author non-byline.; Deacy Dawn author non-byline.; Banerjee Debasish author non-byline.; Caluwe Diane De author non-byline.; Kufeji Dorothy author non-byline.; Cusick Eleri author non-byline.; O'connor Elizabeth author non-byline.; Bough Georgina author non-byline.; Murthi Govind author non-byline.; Patel Hetal author non-byline.; Jones Ian author non-byline.; Sugarman Ian author non-byline.; Njere Ike author non-byline.; Jester Ingo author non-byline.; Durell Jonathan author non-byline.; Cao Kevin author non-byline.; Elmalik Khalid author non-byline.; Tullie Lucinda author non-byline.; Kakade Madhavi author non-byline.; Haneef Maryam author non-byline.; Matcovici Melania author non-byline.; Dawrant Michael author non-byline.; Horridue Michelle author non-byline.; Soares-oliveira Miguel author non-byline.; Doyle Miriam author non-byline.; Shalaby Mohamed author non-byline.; Allan Morven author non-byline.; Burdell Oliver author non-byline.; Charlesworth Paul author non-byline.; Johnson Paul author non-byline.; Hill Richard author non-byline.; Cresner Rosie author non-byline.; Craigie Ross author non-byline.; Gupta Samir author non-byline.; Motiwale Sandeep author non-byline.; Besarovic Sanja author non-byline.; Paramalingam Saravanakumar author non-byline.; Marven Sean author non-byline.; Patel Shailesh author non-byline.; Sharif Shazia author non-byline.; Naqvi Shehryer author non-byline.; Clarke Simon author non-byline.; Kenny Simon author non-byline.; Giuliani Stefano author non-byline.; Payne Susan author non-byline.; Tyraskis Thanos author non-byline.; Tsang Thomas author non-byline.; Bradnock Tim author non-byline.; Calvert William author non-byline.; Patel Yatin author non-byline.;
• Is Part Of: Archives of disease in childhood. Volume 105:Issue 2(2020)
• Page Start: 178
• Page End: 183
• Publication Date: 2019-06-22
• Subjects: neonatology -- paediatric surgery -- epidemiology -- congenital Abnorm; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2019-317085
• Languages: English
• ISSNs: 1359-2998

Abstract

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.