Two Cases of Congenital Duodenal Atresia With Postoperative Anastomotic Ulcers

Masui Daisuke, Hirayama Yutaka, Iinuma Yasushi, Iida Hisataka, Naito Shinichi, Nitta Kouju

doi:10.11164/jjsps.50.7_1132

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晩期合併症として発症した先天性十二指腸閉鎖症術後吻合部潰瘍の2例
症例報告晩期合併症として発症した先天性十二指腸閉鎖症術後吻合部潰瘍の2例
ショウレイホウコクバンキガッペイショウトシテハッショウシタセンテンセイジュウニシチョウヘイサショウジュツゴフンゴウブカイヨウノ 2レイ

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Abstract

Duodenal atresia and stenosis have a good prognosis with few postoperative complications. We encountered 2 patients who developed anastomotic ulcers after undergoing diamond-shaped anastomosis for duodenal atresia. Case 1: A 10-year-old boy was hospitalized owing to tarry stools. An endoscopic examination showed consecutive pocketlike lumina and ulcer with active bleeding near the anastomosis. Case 2: A 9-year-old boy was hospitalized owing to coffee-ground vomit. An endoscopic examination showed a hemorrhagic anastomotic ulcer and consecutive pocketlike lumina near the anastomotic region. An upper gastrointestinal series showed dilatation of the proximal duodenum. Both patients demonstrated gradual resolution following treatment with a proton pump inhibitor and nutritional management without surgical treatment. Regarding the patients’ backgrounds, both boys had autism in conjunction with Down’s syndrome. Because they had been consuming an extremely unbalanced diet, chronic malnutrition induced delayed wound healing, which might be related to ulceration. Clinicians must consider the potential for late complications, such as anastomotic ulcers. It is ideal to regularly perform imaging and nutritional assessments for a long-term follow-up.

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Journal of the Japanese Society of Pediatric Surgeons

Journal of the Japanese Society of Pediatric Surgeons 50 (7), 1132-1136, 2014

The Japanese Society of Pediatric Surgeons

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