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Published in: Pediatric Surgery International 1/2023

01-12-2023 | Trisomy 21 | Original Article

Effect of trisomy 21 on long-term gastrointestinal outcomes in duodenal atresia

Authors: Anna Zrinyi, Suyin A. Lum Min, Emmanuel A. Bello, Charanpal Singh, Richard Keijzer

Published in: Pediatric Surgery International | Issue 1/2023

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Abstract

Purpose

We aimed to determine if Trisomy 21 (T21) affected gastrointestinal outcomes for children with duodenal atresia (DA).

Methods

We identified children born with DA between 1991 and 2017. Cases were divided into DA with T21 and DA without T21. Ten healthy controls per case were included. Esophageal, ulcerative, obstructive and stomach complaints were assessed. Risk ratios (RR), rate ratios (RaR) and Cox models were constructed. Analyses were performed for cases versus controls, and for T21 cases versus non-T21 cases.

Results

DA cases totaled 52: 22 had T21 and 30 did not. There were 520 controls. DA cases had more gastrointestinal complaints than controls. T21 cases were at greater risk and frequency of esophageal disease than non-T21 cases (RR = 4.08, p = 0.002, RaR = 69.8, p < 0.001). T21 and non-T21 cases were equally likely to present with obstruction (RR = 0.91, p = 1), but T21 cases complained of obstructive symptoms less (RaR = 0.57, p = 0.003). T21 and non-T21 cases had the same risk of stomach diseases, but T21 cases complained more frequently (RaR = 6.20, p < 0.001). Cox models supported these observations. T21 did not affect ulcerative diseases.

Conclusion

DA cases had more gastrointestinal problems than controls. T21 increased esophageal and gastric complaints in DA cases but did not affect ulcerative and obstructive complaints.
Literature
1.
go back to reference Escobar MA et al (2004) Duodenal atresia and stenosis: long-term follow-up over 30 years. J Pediatr Surg 39(6):867–871 (discussion 867–871)CrossRefPubMed Escobar MA et al (2004) Duodenal atresia and stenosis: long-term follow-up over 30 years. J Pediatr Surg 39(6):867–871 (discussion 867–871)CrossRefPubMed
2.
go back to reference Keckler SJ et al (2008) The influence of trisomy 21 on the incidence and severity of congenital heart defects in patients with duodenal atresia. Pediatr Surg Int 24(8):921–923CrossRefPubMed Keckler SJ et al (2008) The influence of trisomy 21 on the incidence and severity of congenital heart defects in patients with duodenal atresia. Pediatr Surg Int 24(8):921–923CrossRefPubMed
3.
go back to reference Puri P, O’Donnell B (1981) Outlook after surgery for congenital intrinsic duodenal obstruction in Down syndrome. The Lancet 2(8250):802CrossRef Puri P, O’Donnell B (1981) Outlook after surgery for congenital intrinsic duodenal obstruction in Down syndrome. The Lancet 2(8250):802CrossRef
4.
go back to reference Singh MVA, Richards C, Bowen JC (2004) Does Down syndrome affect the outcome of congenital duodenal obstruction? Pediatr Surg Int 20(8):586–589CrossRefPubMed Singh MVA, Richards C, Bowen JC (2004) Does Down syndrome affect the outcome of congenital duodenal obstruction? Pediatr Surg Int 20(8):586–589CrossRefPubMed
5.
go back to reference Vinycomb T et al (2020) Quality of life outcomes in children born with duodenal atresia. J Pediatric Surg 55(10):2111–2114CrossRef Vinycomb T et al (2020) Quality of life outcomes in children born with duodenal atresia. J Pediatric Surg 55(10):2111–2114CrossRef
6.
go back to reference Niramis R et al (2010) Influence of Down’s syndrome on management and outcome of patients with congenital intrinsic duodenal obstruction. J Pediatr Surg 45(7):1467–1472CrossRefPubMed Niramis R et al (2010) Influence of Down’s syndrome on management and outcome of patients with congenital intrinsic duodenal obstruction. J Pediatr Surg 45(7):1467–1472CrossRefPubMed
7.
go back to reference Mazurek D, Wyka J (2015) Down syndrome–genetic and nutritional aspects of accompanying disorders. Roczniki Państwowego Zakładu Higieny 66(3):189–194PubMed Mazurek D, Wyka J (2015) Down syndrome–genetic and nutritional aspects of accompanying disorders. Roczniki Państwowego Zakładu Higieny 66(3):189–194PubMed
8.
go back to reference Freeman SB et al (2009) Congenital gastrointestinal defects in Down syndrome: a report from the Atlanta and National Down Syndrome Projects. Clin Genet 75(2):180–184CrossRefPubMed Freeman SB et al (2009) Congenital gastrointestinal defects in Down syndrome: a report from the Atlanta and National Down Syndrome Projects. Clin Genet 75(2):180–184CrossRefPubMed
9.
go back to reference Smith MD, Man MP (2019) Feeding outcomes in neonates with trisomy 21 and duodenal atresia. J Surg Res 244:91–95CrossRefPubMed Smith MD, Man MP (2019) Feeding outcomes in neonates with trisomy 21 and duodenal atresia. J Surg Res 244:91–95CrossRefPubMed
10.
go back to reference Maassel NL et al (2021) Institutional variation in gastrostomy tube placement after duodenal atresia repair in children with trisomy 21. J Pediatr Gastroenterol Nutr 73(4):560–565CrossRefPubMed Maassel NL et al (2021) Institutional variation in gastrostomy tube placement after duodenal atresia repair in children with trisomy 21. J Pediatr Gastroenterol Nutr 73(4):560–565CrossRefPubMed
11.
go back to reference Spigland N, Yazbeck S (1990) Complications associated with surgical treatment of congenital intrinsic duodenal obstruction. J Pediatr Surg 25(11):1127–1130CrossRefPubMed Spigland N, Yazbeck S (1990) Complications associated with surgical treatment of congenital intrinsic duodenal obstruction. J Pediatr Surg 25(11):1127–1130CrossRefPubMed
12.
go back to reference Zárate N et al (2001) Prospective evaluation of esophageal motor dysfunction in Down’s syndrome. Am J Gastroenterol 96(6):1718–1724CrossRefPubMed Zárate N et al (2001) Prospective evaluation of esophageal motor dysfunction in Down’s syndrome. Am J Gastroenterol 96(6):1718–1724CrossRefPubMed
13.
go back to reference Macchini F et al (2011) Treating acid reflux disease in patients with Down syndrome: pharmacological and physiological approaches. Clin Exp Gastroenterol 4(1):19–22CrossRefPubMedPubMedCentral Macchini F et al (2011) Treating acid reflux disease in patients with Down syndrome: pharmacological and physiological approaches. Clin Exp Gastroenterol 4(1):19–22CrossRefPubMedPubMedCentral
14.
go back to reference Grosfeld JL, Rescorla FJ (1993) Duodenal atresia and stenosis: Reassessment of treatment and outcome base on antenatal diagnosis, pathologic variance, and long-term follow-up. World J Surg 17:301–309CrossRefPubMed Grosfeld JL, Rescorla FJ (1993) Duodenal atresia and stenosis: Reassessment of treatment and outcome base on antenatal diagnosis, pathologic variance, and long-term follow-up. World J Surg 17:301–309CrossRefPubMed
15.
go back to reference Bairdain S et al (2014) A modern cohort of duodenal obstruction patients: predictors of delayed transition to full enteral nutrition. J Nutr Metab 2014:850820CrossRefPubMedPubMedCentral Bairdain S et al (2014) A modern cohort of duodenal obstruction patients: predictors of delayed transition to full enteral nutrition. J Nutr Metab 2014:850820CrossRefPubMedPubMedCentral
Metadata
Title
Effect of trisomy 21 on long-term gastrointestinal outcomes in duodenal atresia
Authors
Anna Zrinyi
Suyin A. Lum Min
Emmanuel A. Bello
Charanpal Singh
Richard Keijzer
Publication date
01-12-2023
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 1/2023
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-022-05359-w

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