Journal of Hepatology and Gastrointestinal disorders
Open Access

Duodenal Obstruction

Duodenal obstruction in neonates and infants should be considered a surgical emergency until the diagnosis of malrotation with potential midgut volvulus can be ruled out. In a neonate with a presentation of duodenal obstruction, an upper gastrointestinal (GI) contrast study needs to be obtained urgently to establish the presence of a GI rotational abnormality. If malrotation cannot be ruled out by contrast study, these neonates require surgery to rule out malrotation and treat the obstruction. In neonates with normal gastrointestinal rotation and in adults, the evaluation and management of duodenal obstruction can proceed at a less urgent pace as the likelihood of bowel infarction from a midgut volvulus is low. In a neonate, the initial therapeutic effort is directed toward correcting volume deficits and any electrolyte abnormalities and toward nasogastric decompression.