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Pediatric Surgery International
Published in: Pediatric Surgery International 1/2019

01-01-2019 | Original Article

Duodenal atresia and associated intestinal atresia: a cohort study and review of the literature

Authors: Maria Enrica Miscia, Giuseppe Lauriti, Pierluigi Lelli Chiesa, Augusto Zani

Published in: Pediatric Surgery International | Issue 1/2019

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Abstract

Purpose

To determine the true incidence of associated intestinal atresia (AIA) in infants with duodenal atresia (DA) and to analyze whether the surgical approach, open versus laparoscopic, would impact on patient outcome when AIA is present.

Methods

Cohort study We review all DA infants treated at our institution (2001–2016) and analyzed the outcome of those with AIA. Systematic review/meta-analysis Using a defined search strategy and according to PRISMA guidelines, two investigators independently identified all studies on DA and searched cases of AIA to determine its incidence. Data are mean ± SD.

Results

Cohort study Of 140 DA infants, 10 (7%) had AIA (4 type I, 4 type III, 2 type II). All type I AIA (webs) were found in the duodenum. Systematic review/meta-analysis Of 840 studies, 18 were included (2026 infants). The incidence of AIA was 2.8 ± 1.6%. The incidence of missed AIA was 0.8 ± 2.4%. Three comparative studies (759 infants) showed higher risk of missed AIA following laparoscopic (2.9 ± 2.4%) than open repair (0.3 ± 0.1%; p < 0.01).

Conclusions

The incidence of AIA in DA infants is low and the risk of missing it is higher at laparoscopy than at laparotomy. Regardless the approach, surgeons should carefully investigate bowel continuity to avoid the risk of missing AIA.
Appendix
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Metadata
Title
Duodenal atresia and associated intestinal atresia: a cohort study and review of the literature
Authors
Maria Enrica Miscia
Giuseppe Lauriti
Pierluigi Lelli Chiesa
Augusto Zani
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 1/2019
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-018-4387-1

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