Clin Endosc.  2017 Mar;50(2):191-196. 10.5946/ce.2016.093.

Persistent Nonbilious Vomiting in a Child: Possible Duodenal Webbing

• Angotti R
• Molinaro F
• Cobellis G
• Noviello C
• Bocchi C
• Ferrara F
• Bindi E
• Messina M

• KMID: 2383537
• DOI: http://doi.org/10.5946/ce.2016.093

Abstract

An association between malrotation and congenital duodenal webbing is rare. We present our experience with four patients at two centers, and a review of published reports. There are currently 94 reported cases of duodenal pathology associated with malrotation. However, only 15 of the 94 cases (15.9%) include patients with malrotation and a duodenal web. We suggest that nonbilious vomiting in a child must prompt the surgeon to consider duodenal pathology even in the presence of malrotation.

Keyword

Congenital duodenal web; Malrotation; Child; Nonbilious vomiting

MeSH Terms

Child*
Humans
Pathology
Vomiting*

Figure

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  Fig. 1. Case 1: 2-year-old girl. (A, B) An endoscopic picture of her congenital duodenal web. This is a view during an endoscopic procedure. (B) The tag shows the bulging of the duodenal web.

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  Fig. 2. Case 3: 10-year-old girl. (A, B) An upper gastrointestinal contrast study shows a duodenal stenosis with delayed emptying of the 2nd duodenal portion (red arrow) and all of the small bowel in the right quadrant and the colon in the left quadrant because of a previous Valdoni’s procedure.

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  Fig. 3. Case 4. (A-D) Prenatal ultrasound shows the presence of a double bubble that was suspected to be a duodenal pathology.

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