Retrospective Analysis Of 63 Cases Of Congential Duodenal Obstruction

Objective:To summarize the clinical features of the congenital duodenal obstruction (CDO),early diagnosis and treatment methods, investigate the possible factors that affect the postoperative recovery and complications.Methods:A retrospective analysis of the First Affiliated Hospital, Guangxi Medical University Pediatric Surgery accepted admission after surgical treatment of 63 cases of CDO from January 2009 to December 2015, summarized CDO clinical features and treatment, using the chi-square test or exact method (T<1) to compare the difference of age of onset, clinical symptoms, imaging findings. And analysis the correlation of pathological type, surgical, preoperative vomiting, low potassium or low sodium electrolyte disturbance, albumin or hemoglobin decreased, birth age, weight, gestational age, score, whether complicated with pneumonia, with intestinal malformation post-operative defecation and eating time, wherein the measurement data using multiple linear regression analysis, count data using analysis of variance, when the value of P<0.05, the difference was statistically significant. All data were processed by the SPSS 22.0 software for statistical.Results:(1)Children with congenital duodenal obstruction in 63 cases,31 cases of intestinal malrotation (49.2%), duodenal atresia or stenosis in 15 cases (23.8%), annular pancreas in 10 cases (15.87%), while the two combined species obstruction 7 cases (11.11%),37 cases of newborn, infants in 11 cases, 11 cases of infants, children under 7 cases, bilious vomiting in 43 cases (68.25%). (2)Abdominal B ultrasound, upper gastrointestinal contrast, CT, KUB diagnostic yield respectively of 61.53%(8/13),92.85%(39/42),75%(6/8), 57.14%(36/63), prenatal line B-seven cases, all confirmed. The main factors that cause the time of diagnosis and treatment were not timely and effectively. The group underwent surgery and 62 patients were cured (98.14%), and 1 died. Postoperative complications included anastomotic leakage (1 case), adhesive intestinal obstruction (3 cases), wound infection (1 case), intraoperative and gentle double-check operation is the key to reduce postoperative complications. (3)Malrotation group defecation, eating time was 3.03d,5.35d, early (P= 0.038,0.000) than other types of pathology. Corresponding compared to other surgical methods with Ladd surgery patients eating earlier (p=0.019), preoperative biliary vomiting eating time was 5.6d, no vomiting compared with preoperative earlier (p=0.046), no defecation preoperative pneumonia earlier (p =0.005).Conclusions:(1)Congenital duodenal obstruction occur in newborns, the incidence decreased with age, the most common disease cause of intestinal malrotation. (2)The popularity of the prenatal ultrasound and children with bilious vomiting as early as possible in upper gastrointestinal contrast and further check to earlier diagnosis. (3)surgery should be a reasonable choice depending on the type of pathology, strengthen perioperative management, correcting the disturbance of water and electrolyte, anemia, and hypoalbunemia, aggressive treatment of pneumonia in order to facilitate postoperative recovery and reduce the incidence of postoperative complications.