Department of Pediatrics, Maiwand Teaching Hospital, Kabul University of Medical Sciences, 1st District, Jada-e-Maiwand, 1001, Kabul, Afghanistan.
Department of Pediatric Surgery, Kabul University of Medical Sciences, Kabul, Afghanistan.
J Med Case Rep. 2023 Nov 24;17(1):507. doi: 10.1186/s13256-023-04179-3.
The duodenal web is a thin, elongated, web-like structure that is one of the factors contributing to duodenal obstruction. Only 100 cases have been reported in the literature. We present a 2.5-year-old cachectic Afghan child who did not have any overt signs and symptoms of intestinal obstruction, like recurrent vomiting, abdominal distention, and weight loss. The web was discovered near the intersection of the third and fourth portions, which is an uncommon location for the duodenal web. The late presentation of congenital duodenal web with partial obstruction is rare but well-known and has been reported in this case.
A 2.5-year-old cachectic Afghan child who had recurrent vomiting and experienced abdominal distention was brought to Maiwand Teaching Hospital from the Jabelsuraj region of Parwan province. The patient was suffering from unusual signs and symptoms like recurrent vomiting, abdominal distention, weight loss, and constipation. The diagnosis of these anomalies was established by a detailed history, clinical features, and abdominal CT scan. In the computerized tomography scanning (CT-Scan) image reported, there was a web with stenosis and partial obstruction in the distal aspect of the third-to-fourth portion of the duodenum. After preoperative stabilization, the child was taken for surgery. The abdomen was opened by a right upper abdominal transverse incision. After web resection and duodenoplasty, the patient was shifted to the recovery room in satisfactory condition. The child was allowed to feed after 8 days, which he tolerated well.
Congenital duodenal web with partial obstruction is typically observed in the second and third years of life. It is suspected in patients with recurrent vomiting, abdominal distention, weight loss, and constipation. Partial obstruction may not have an overt presentation, making it a challenging diagnosis for general practitioners. Abdomen X-ray and CT scan usually confirm the diagnosis, and successful surgical intervention is recommended.
十二指肠隔膜是一种薄而细长的膜状结构，是导致十二指肠梗阻的因素之一。文献中仅报道了 100 例病例。我们报告了一名 2.5 岁消瘦的阿富汗儿童，他没有任何明显的肠梗阻症状，如反复呕吐、腹胀和体重减轻。该隔膜位于第三和第四部分的交界处附近，这是十二指肠隔膜的一个不常见位置。先天性十二指肠隔膜伴部分梗阻的迟发性表现较为罕见，但已被报道，本病例即属此类。
一名消瘦的 2.5 岁阿富汗儿童，因反复呕吐和腹胀，从帕尔旺省的贾贝尔苏拉杰地区被送往迈万德教学医院。患者出现了一些不常见的症状，如反复呕吐、腹胀、体重减轻和便秘。这些异常的诊断是通过详细的病史、临床特征和腹部 CT 扫描确定的。在报告的计算机断层扫描（CT 扫描）图像中，显示第三至第四部分的远端有隔膜狭窄和部分梗阻。在术前稳定后，患儿接受了手术。通过右上腹部横切口进行剖腹手术。在进行隔膜切除和十二指肠成形术后，患儿被转移到恢复室，情况良好。患儿在 8 天后开始进食，情况良好。
先天性十二指肠隔膜伴部分梗阻通常发生在生命的第二和第三年。在反复呕吐、腹胀、体重减轻和便秘的患者中怀疑有这种疾病。部分梗阻可能没有明显的表现，这对全科医生来说是一个具有挑战性的诊断。腹部 X 射线和 CT 扫描通常可确诊，建议进行成功的手术干预。
