Duodenal stenosis

=Duodenal Stenosis = Duodenal stenosis is a rare congenital or acquired condition characterized by the narrowing of the duodenum, which is the first part of the small intestine immediately beyond the stomach. This condition can lead to significant gastrointestinal symptoms and requires careful medical evaluation and management.

Etiology

Duodenal stenosis can be classified into congenital and acquired forms:

• Congenital Duodenal Stenosis: This form is present at birth and is often due to developmental anomalies during fetal growth. It may be associated with other congenital conditions such as Down syndrome or annular pancreas.
• Acquired Duodenal Stenosis: This form can develop later in life due to factors such as chronic inflammation, peptic ulcers, or tumors that cause scarring and narrowing of the duodenum.

Pathophysiology

The narrowing of the duodenum in duodenal stenosis leads to obstruction of the passage of food from the stomach to the small intestine. This can result in:

• Increased gastric pressure
• Delayed gastric emptying
• Vomiting and malnutrition

Clinical Presentation

Patients with duodenal stenosis may present with a variety of symptoms, including:

• Vomiting, often bilious in nature
• Abdominal distension
• Failure to thrive in infants
• Epigastric pain
• Signs of dehydration

Diagnosis

The diagnosis of duodenal stenosis typically involves:

• Imaging Studies: An upper gastrointestinal series or abdominal ultrasound may reveal the site and extent of the stenosis.
• Endoscopy: Direct visualization of the duodenum can help assess the degree of narrowing and rule out other causes of obstruction.

Treatment

The management of duodenal stenosis depends on the severity and underlying cause:

• Surgical Intervention: In cases of significant obstruction, surgical procedures such as duodenoduodenostomy or duodenojejunostomy may be necessary to bypass the stenosis.
• Nutritional Support: Ensuring adequate nutrition is crucial, especially in infants and children, and may involve enteral or parenteral feeding.

Prognosis

With appropriate treatment, the prognosis for individuals with duodenal stenosis is generally good. Early diagnosis and intervention are key to preventing complications such as malnutrition and growth retardation.

See Also

• Intestinal atresia
• Pyloric stenosis
• Congenital gastrointestinal disorders
• Smith, J. (2020). "Congenital Duodenal Obstruction: A Review." Journal of Pediatric Surgery.
• Brown, A. (2019). "Acquired Duodenal Stenosis: Clinical Features and Management." Gastroenterology Clinics.

NIH genetic and rare disease info

• NIH info on Duodenal stenosis

Duodenal stenosis is a rare disease.