Abstract Ref Number = APCP873
Congenital Duodenal Web In 1 Month Year Old Girl
Wirantari Ni Putu,Karyana Putu Gde,Sanjaya Putra IGN,Metriani Nesa Ni Nyoman,Darmajaya I Made,Deddy Ariyanta Kadek
Department of Child Health Udayana University Department of Child Surgical Udayana University
Background : Congenital web of the gastrointestinal tract is a rare anomaly causing gastrointestinal obstruction in infants and children. It is a rare condition with approximately 100 cases reported in the literature with a reported incidence ranging from 1 in 10,000 to 1 in 40,000. The severity of symptoms and the age of onset vary according to the size and location of the web, and if the obstruction is total or partial. When the obstruction is incomplete, as it was in our case, the clinical symptoms are variable and the diagnosis can be difficult.
Case Presentation Summary : A one month old girl was hospitalized with history of vomiting since she was born. Frequency of vomiting about 2 to 3 episodes per day with volume was 3-5 spoons without bilious colour. There were no history of fever, jaundice, bloating. Laboratory investigation showed hypokalemia and cholestasis. Babygram radiography revealed “single bubble appearance” in cavum abdomen that suggested to Hypertropic Pylorus Stenosis. Upper gastrointestinal study showed partial stenosis in pylorus and distal bulbus duodeni, duodenal web can not be excluded and not supported to hypertropic pylorus stenosis. Patient underwent an exploratory laparotomy, which revealed a partial obstruction caused by duodenal web hole type at duodenal pars II pre ampula vater then web excision and duodenoplasty with primary hecting was conducted. On the 21th days post operation, she was discharged from hospital in good condition.
Learning Points/Discussion : In duodenal web case when the obstruction is incomplete, the clinical symptoms are variable and the diagnosis can be difficult.
Keywords: Duodenal Web Congenital