duodenal atresia
TRANSCRIPT
Duodenal atresia20150410
Introduction
● congenital disease● 1/5000-10000● 20-40% : Down ● (but 8% in Down)● 30-52% isolated anomaly● 20-25% have cardiac anomalies
autosomal recessive
Cause● annular pancreas● duodenal growth failure failure of recanalization
● biliopancreatic tract or choledochal cysts
Recanalization of duodenum
ClassificationType I (duodenal diaphragm)
Type II (complete a duodenal atresia)
Type III(complete separation of the two ends)annular pancreas
92%
1%
7%
Ultrasound findings
● Polyhydramnios● "double bubble"
Diagnosis 80-90%
Diagnosis
● Polyhydramnios● abdominal distension● Bilious vomiting● "double bubble" sign
Diagnosis
ampuIa of vater
90% Bilious vomiting
Treatment
● nasogastric tube● surgery (duodenoduodenostomy)● 5% percent morbidity and mortality rate● Prognosis is usually good● rare late complicationsmegaduodenumblind loop syndromeduodenogastric refluxesophagitispancreatitischolecystitis and cholelithiasis
Differential diagnoses
● late appearing pyloric stenosis● incomplete diaphragm● other forms of intestinal atresia● common mesenteric intestinal volvulus● duodenal duplication
Differential diagnoses
Small Bowel Obstructionduodenal duplication
incomplete diaphragm
Syndrome
● Miller-Dieker Syndrome● Trisomy 21
Teratogens● Chlordiazepoxide● Fluorouracil● Thalidomide
Syndrome
● Miller-Dieker Syndrome● Trisomy 21
Teratogens● Chlordiazepoxide● Fluorouracil● Thalidomide
利眠寧 治療精神障礙藥物Cardiac defectsDuodenal atresiaMicrocephaly
服樂癌注射劑Esophageal and Duodenal abnormalitiesRadial aplasia
賽得膠囊(沙利竇邁) 治療痲瘋性結節紅斑Cardiac defects MicrotiaDuodenal atresia Spine malformationsLimb reduction abnormalities
Refference
http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Expert=1203http://en.wikipedia.org/wiki/Duodenal_atresiahttp://yibian.hopto.org/diag/ill/?illno=811