Duodenal atresia represents complete obliteration of the duodenal lumen, with condition of duodenum do notfunctioning good so that do not in the form of open channel from stomach whichdo not enable food journey from stomach to intestine.
The term of duodenal diaphragm or duodenal web is thought to represent a mild form of atresia. Incomplete obstruction of the duodenal lumenor so-called duodenal stenosis often related with duodenal atresia because these two disorders together represent a spectrum of similar intr auterine events.
In most cases, duodenal atresia occurs below the ampulla of Vater. In a veryfew cases, the atresia occurs proximal to the ampulla. The etiology of duodenal atresia and stenosis is unknown. Duodenal atresia linked with malformation of neonatal that be caused trouble of growth at pregnancy early days and trouble of mesenteric venous at growth hereinafter. Infants with duodenal atresia present with vomiting in their first few hours of life. Trouble of growth duodenumhappened as a effect of proliferation of endodermal that do not adequate (elongation digestive tract exceeding proliferation ) or failure recanalization solid ribbon epithelial ( failure of process vacuolization ).
Clinical symptom duodenal atresia include :
Can be found bloated at upper abdomen.
Bile-stained vomit in neonates aged 24 hours or younger as aeffect of existence of bile ( bilious ), and continuous vomit although babyfasted during several hours.
Urine there is no after several times urinate.
The characteristic of duodenal atresia are plain radio graphs that demonstrate a double-bubble appearance with no distal gas. Distal bowelgas indicates stenosis, incomplete membrane, or a hepatopancreatic ductalanomaly.
After born, baby have abdomen scafoid is the typically presentation of duodenal atresia.
If duodenal atresia or significant duodenal stenosis is left untreated, the condition rapidly becomes fatal as a result of electrolyte lossand fluid imbalance, duodenal atresia have to immediately obtaining medical treatment with important reason as follow :
Hydramnios occurs in approximately 40% of neonates with duodenal obstruction.
Duodenal atresia or duodenal stenosis is most commonly associated with trisomy 21 or so-called down syndrome. Trisomy 21 as aimportant problem because associated with cardiac defects ( most commonly ventricular septal defects and endocardial defects ), as well as Hirsch sprung disease.
Medical treatment at duodenal atresia through tubeorogastrik can be attached for the decompression of stomach. Dehydration and electrolyte imbalance can be corrected by giving electrolyte and dilution through intravenous. Do also evaluate at another congenital anomaly. Surgery for correcting impasse of duodenum require to be done but do not emergency.Approach of surgery depend on abnormalities. Procedure operative standard this time in the form of duodenoduodenostomy through incision at upper quadran tright side.
Differential diagnoses duodenal atresia include :
- Oesophagus atresia
- Malrotation with mid gut volvulus
- Pylorus stenosis
- Annular pancreas
- Preduodenal portal vein
- Intestine atresia
- Duplication of duodenum
- Obstruction of foreign object
- Hirschsprung disease
- Reflux gastroesofageal
- Ladd bands
- Abdominal aortic aneurysm
.jpg)
0 komentar:
Posting Komentar