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Duodenal diaphragm diagnosis in a school-aged child and minimally invasive treatment: case report

Diagnóstico de diafragma duodenal en edad escolar y manejo mínimamente invasivo: reporte de caso

Abstract

Duodenal atresia is the third cause of intrinsic intestinal obstruction in the neonatal period. Typical presentation includes early-onset vomiting of gastric or bilious content, abdominal distension and poor weight gain. If the obstruction is incomplete, as in a perforated duodenal diaphragm, presenting symptoms tend to appear later and be nonspecific, so diagnosis is usually delayed. We present the case of a 9-year-old girl with a history of biliary postprandial vomiting from the infancy period, without any impact on the nutritional status, managed symptomatically. At two years of age, an upper digestive endoscopy was performed, which was frustrated by an abundance of gastric contents. She is again studied at nine years of age with contrasting upper digestive tract and upper digestive endoscopy, which suggest the diagnosis of fenestrated duodenal membrane. Duodeno-jejunum anastomosis is performed in Roux-en-Y, with a good postoperative outcome.

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