Duodenal Atresia in a High-Complexity Referral Center in Medellin, Colombia: A Report of Three Cases

Echavarria A and Maya SA

Published on: 2025-08-27

Abstract

Introduction: Duodenal atresia is a rare congenital anomaly that causes high intestinal obstruction in the newborn. In a large proportion of cases, it is associated with chromosomal antenatal pathologies. Early diagnosis and prompt surgical management can improve prognosis. We present three clinical cases with very diverse presentations, managed at a high-complexity center in Medellín.

Case Presentation

Case 1: Full-term newborn, appropriate weight for gestational age, with prenatal trisomy 21 and ultrasound suspicion of duodenal atresia due to the “double bubble” sign. The condition was confirmed postnatally as type III associated with annular pancreas, and a diamond-shaped duodenoyeyunal anastomosis was performed on day 3 of life, with adequate postoperative evolution and initiation of oral feeding within the expected time period.

Case 2: Twenty-seven-day-old infant with persistent abundant vomiting since birth and failure to thrive, diagnosed with type I duodenal atresia (duodenal diaphragm), managed with duodenoyeyunostomy, showing adequate postoperative course and full return to enteral nutrition by day 15 of life.

Case 3: Premature infant born at 31 + 3 weeks’ gestation with incidental finding of complex “Christmas tree” malformation and multiple intestinal atresias, including duodenal atresia, requiring intestinal resection and reconstruction with associated microcolon; patient remains under progressive recovery with late dependence on enteral nutrition.

Discussion: Duodenal atresia presents marked anatomical and clinical variability, resulting in diagnostic challenges, particularly in the absence of prenatal suspicion. As described in the literature, associated anomalies such as trisomy 21, congenital heart disease or intestinal malformations directly impact management and prognosis, reflected in this case series. A multidisciplinary approach, neonatal intensive care and current surgical techniques provide high survival even in the most complex scenarios.

Conclusion: Duodenal atresia encompasses a broad clinical spectrum and associated conditions during its development. These three cases highlight the importance of timely diagnosis, appropriate use of diagnostic tools, individualized management and specialized support in high-complexity centers, enabling favorable outcomes even in premature or genetically compromised patients.