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Dual duodenojejunostomies in the repair of megaduodenum, duodenal stenosis and prior missed diagnosis of annular pancreas.

Authors:
Lily Ye Chen Victor F Cabrera-Bou Adela T Casas-Melley

BMJ Case Rep 2022 Feb 28;15(2). Epub 2022 Feb 28.

University of Central Florida College of Medicine, Orlando, Florida, USA.

Duodenal stenosis and atresia are some of the most common forms of congenital bowel obstruction. The gold standard approach to treatment is duodenoduodenostomy, while rare, gastrojejunostomy and duodenojejunostomies may still be used. We report a case of a 7-year-old male presenting with annular pancreas with duodenal stenosis that was diagnosed at birth as primary duodenal atresia and repaired by gastrojejunostomy with a Braun enteroenterostomy. Through successful reoperation with dual duodenojejunostomy and subsequent management, we treated the sequelae of the initial repair, including megaduodenum. Regions of duodenal obstruction must have direct anastomotic repair to prevent subsequent issues related to dysmotility. Otherwise, further surgical intervention and long-term medical management, such as the novel strategy reported, may be necessary.

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http://dx.doi.org/10.1136/bcr-2021-248219DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886397PMC
February 2022

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