Department of Pediatrics, Children's Mercy Hospitals & Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64108, USA.
J Perinatol. 2010 Mar;30(3):197-200. doi: 10.1038/jp.2009.143. Epub 2009 Oct 1.
To determine age at diagnosis for congenital duodenal obstruction in the neonatal period and the relationship to clinical outcomes.
A children's hospital database reflecting a 7 (1/2)-year period was reviewed to identify infants with the diagnosis of duodenal obstruction in the neonatal period. Infants were grouped according to time of diagnosis: antepartum, postpartum in-hospital or after hospital discharge. Clinical descriptors and outcome variables were assessed between infants in these three groups.
In total, 27/51 (53%) infants were diagnosed antenatally. Infants with prenatal diagnosis were less mature, more likely to have Down syndrome or other birth defects and the pregnancy was more likely to be complicated by polyhydramnios. Of the 24 infants diagnosed postnatally, 8 (33%) were diagnosed after hospital discharge. These infants tended to be breast fed and discharged before 48 h of age. They had greater weight loss and more metabolic disturbances at readmission for surgery. One infant in the late diagnosis group died.
Infants with congenital duodenal obstruction, particularly if breast fed, may not present with classical findings of upper gastrointestinal obstruction in the first days of life. Careful in-hospital evaluation of infants with persistent regurgitation, even low volume, is recommended to avoid missing this diagnosis.
确定新生儿期先天性十二指肠梗阻的诊断年龄与临床结局的关系。
回顾了一家儿童医院反映 7 年半的数据库，以确定新生儿期患有十二指肠梗阻的婴儿。根据诊断时间将婴儿分为三组：产前、住院产后或出院后。评估这三组婴儿的临床特征和结局变量。
共有 27/51（53%）名婴儿被产前诊断。产前诊断的婴儿发育不成熟，更有可能患有唐氏综合征或其他出生缺陷，且妊娠更可能并发羊水过多。24 名产后诊断的婴儿中，有 8 名（33%）在出院后被诊断。这些婴儿更倾向于母乳喂养，并且在 48 小时内出院。他们在因手术再次入院时体重减轻更多，代谢紊乱更严重。迟发型诊断组中有一名婴儿死亡。
患有先天性十二指肠梗阻的婴儿，尤其是母乳喂养的婴儿，在生命的最初几天可能不会出现上消化道梗阻的典型表现。建议对持续反流（即使是少量反流）的婴儿进行仔细的住院评估，以避免漏诊。
