Duodenal atresia
URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/001131.htm
Causes
The cause of duodenal atresia is unknown, but it is thought to result from problems during an embryo's development in which the duodenum does not normally change from a solid to a tube-like structure.Duodenal atresia is seen in more than 1 in 10,000 live births. Approximately 20-30% of infants with duodenal atresia have Down syndrome. Duodenal atresia is often associated with other birth defects.
Symptoms
- Upper abdominal swelling may or may not be present
- Early vomiting of large amounts, which may be greenish (containing bile)
- Continued vomiting even when infant has not been fed for several hours
- Absent urination after first few voidings
- Absent bowel movements after first few meconium stools
Exams and Tests
A fetal ultrasound may show excessive amounts of amniotic fluid in the womb, a condition called polyhydramnios. It may also show swelling of the baby's stomach and part of the duodenum.An abdominal x-ray may show air in the stomach and first part of duodenum, with no air beyond that. This is known as the double-bubble sign.
Treatment
A tube is placed to decompress the stomach. Dehydration and electrolyte abnormalities are corrected by providing fluids through an intravenous tube. An evaluation for other congenital anomalies should be performed.Surgery to correct the duodenal blockage is necessary, but is not an emergency. The surgical approach will depend on the nature of the abnormality. Associated problems (such as those related to Down syndrome) must be treated as appropriate.
Esophageal atresia
URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/000961.htm
Esophageal atresia is a disorder of the digestive system in which the esophagus does not develop properly. The esophagus is the tube that normally carries food from the mouth to the stomach.
Causes
Esophageal atresia is a congenital defect, which means it occurs before birth. There are several types. In most cases, the upper esophagus ends and does not connect with the lower esophagus and stomach. The top end of the lower esophagus connects to the windpipe. This connection is called a tracheoesophageal fistula (TEF). Some babies with TEF will also have other problems, such as heart or other digestive tract disorders.Other types of esophageal atresia involve narrowing of the esophagus, and may also be associated with other birth defects.
Esophageal atresia occurs in about 1 out of 4,000 births.
Symptoms
- Bluish coloration to the skin (cyanosis) with attempted feedings
- Coughing, gagging, and choking with attempted feeding
- Drooling
- Poor feeding
Exams and Tests
Before birth, an ultrasound performed on the pregnant mother may show too much amniotic fluid, which can be a sign of esophageal atresia or other blockage of the digestive tract.The disorder is usually detected shortly after birth when feeding is attempted and the infant coughs, chokes, and turns blue. As soon as the diagnosis is suspected, an attempt to pass a small feeding tube through the mouth or nose into the stomach should be made. The feeding tube will not be able to pass all the way to the stomach in a baby with esophageal atresia.
An x-ray of the esophagus shows an air-filled pouch and air in the stomach and intestine. If a feeding tube has been inserted, it will appear coiled up in the upper esophagus.
Treatment
Esophageal atresia is considered a surgical emergency. Surgery to repair the esophagus should be done quickly after the baby is stabilized so that the lungs are not damaged and the baby can be fed.Before the surgery, the baby is not fed by mouth. Care is taken to prevent the baby from breathing secretions into the lungs.
