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DOI: 10.1055/s-0031-1277134
© Georg Thieme Verlag KG Stuttgart · New York
A Rare Case of Duodenal Atresia with Apple-peel Configuration of the Small Intestine and Malrotation
Publication History
Publication Date:
06 May 2011 (online)
![](https://www.thieme-connect.de/media/ejps/201105/lookinside/thumbnails/10.1055-s-0031-1277134-1.jpg)
Introduction
According to the current understanding, errors in recanalization during the early gestation period lead to duodenal atresia. Duodenal atresia differs from intestinal atresias in other parts of the bowel, which are thought to result from vascular accidents during later phases of gestation [1] [2] [3]. We report a rare case of duodenal atresia with apple-peel configuration of the remaining small intestine, an absent superior mesenteric artery and associated malrotation in a preterm child, which indicates that in rare circumstances vascular accidents may be the underlying cause of duodenal atresia [4]. This is the 4th such case to be reported in the English literature [4] [5] [6].
References
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- 2 Gross E, Armon Y, Abu-Dalu K. et al . Familial combined duodenal and jejunal atresia. J Pediatr Surg. 1996; 31 1573
- 3 Lambrecht W, Kluth D. Hereditary multiple atresias of the gastrointestinal tract: Report of a case and review of the literature. J Pediatr Surg. 1998; 33 794-797
- 4 Weber DM, Freeman NV. Duodenojejunal atresia with apple-peel configuration of the ileum and absent superior mesenteric artery: Observations on pathogenesis. J Pediatr Surg. 1999; 34 1427-1429
- 5 Arbell D, Orkin B, Naveh Y. et al . Duodenojejunal atresia with absent dorsal mesentery, choledochal cyst, and malrotation in a premature newborn – a case report. J Pediatr Surg. 2006; 41 (6) e11-e13
- 6 Ahmad A, Sarda D, Joshi P. et al . Duodenal atresia with ‘apple-peel configuration’ of the ileum and absent superior mesenteric artery: A rare presentation. Afr J Paediatr Surg. 2009; 6 (2) 120-121
- 7 Fonkalsrud EW, De Lorimier AA, Hays DM. Congenital atresia and stenosis of the duodenum. Pediatrics. 1969; 43 79-83
- 8 Santulli TV, Blanc WA. Congenital atresia of the intestine: Pathogenesis and treatment. Ann Surg. 1961; 154 939-948
- 9 Lister J. Intestinal atresia and stenosis, excluding the duodenum.. In: Lister J, Irving I, Rickham PP , editors. Neonatal Surgery London, UK: Butterworth and Co; 1990: 453-473
Correspondence
Dr. Rjashekhar T PatilMCh ped surg (senior resident)
Seth GS Medical College and KEM Hospital
Pediatric Surgery
Room no. 1213
New MS Building
400012 Mumbai
India
Phone: +91 93 2036 5684
Fax: +91 22 2414 3435
Email: dr_rajpatil01@yahoo.com