hi i had my 20 weeks scan and i have found out my baby son has a duodenum blockage and my other baby had it to will he be ok

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Vicki - posted on 06/19/2009

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The duodenum is the piece of the intestine which runs between the stomach and the small intestine. Duodenal obstruction (blockage) may be appreciated when the baby is inside the mother on in-utero ultrasound when polyhydramnios (too much fluid around the fetus) and duodenal dilatation (enlarged duodenum) are observed. In the first 24-48 hours of life, inability to feed and vomiting are often noted. The abdomen is not usually distended. An x-ray may show a "double bubble" with an air-filled and enlarged stomach and an air-filled, enlarged duodenum. The rest of the small intestine and colon will remain gasless until a partial duodenal blockage is present. If a classic double bubble is observed, then further x-rays are usually unnecessary. Approximately 30% of newborns with duodenal blockage will have Trisomy 21 or Down's syndrome. As long as intestinal malrotation (twisting of the small intestine) has been excluded, emergent operation is not necessary. However, in most cases prompt operation is appropriate.







Congenital duodenal blockage typically is from one of the following: 1) an annular pancreas in which a ring of pancreatic tissue either completely or partially surrounds the duodenum with complete or partial blockage; 2) a duodenal atresia or complete blockage of the duodenum; or 3) a stenosis (partial blockage) due to either intestinal malformation (twisting) or a web with a narrow opening. Atresias and stenoses most commonly occur where the bile duct coming from the liver enters the duodenum. Other bowel blockages rarely exist with a duodenal blockage. A right upper abdominal incision allows identification of the enlarged upstream duodenum and the small downstream duodenum. In general, bypass of the blocked area by joining a hole in the upstream duodenum with a hole in the downstream duodenum is the best approach. If a relatively wide gap between the two ends of the duodenum makes this difficult, then a loop of small intestine may be brought up to the duodenum and a duodenojejunostomy (joint between the duodenum and small intestine) performed.







Complications

Problems or deaths are usually due to associated complications from early birth, Trisomy 21, and heart disease. It is not uncommon for it to require several days to weeks before the duodenum functions appropriately allowing feeding to be tolerated.

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