Congenital Duodenal Anomalies in the Adult

Open Access
Publisher Website
Google Scholar
Abstract
CONGENITAL duodenal anomalies are rare lesions and originate in the early embryologic development of the foregut. Whereas the primitive foregut undergoes lengthening and rotation, the hepatobiliary and pancreatic anlagen begin as buds or diverticula at the middle of the duodenum and similarly grow and rotate. During this period, duodenal atresias, intraluminal webs, annular and ectopic pancreata, and malrotations of various types develop. The delayed presentation of these anomalies in the adult is difficult to explain, but the presence of a dilated stomach and a proximal duodenal bulb with a patulous pylorus suggests a progressive loss of compensatory peristaltic action to overcome a small duodenal aperture or narrowing of the descending duodenum. Most studies of these lesions are single case reports or small series, which do not allow a single surgeon to accumulate extensive experience; therefore, reliance on the combined experience of others in recognition and appropriate management has been the norm. This article presents a recent series of adult patients with duodenal webs, annular pancreata, or a combination of these 2 anomalies. Recognition and a rational approach to correction of these problems is based on the appropriate treatment for each patient and a knowledgeable expectation of the outcome based on the chosen therapy.

This publication has 11 references indexed in Scilit: