Postoperative Duodenal Stricture in a Neonate with Duodenal Atresia – Innovative Approach and Lessons Learned

Authors

Raniah I. Alnaser, Nineveh Health Directorate, Mosul, Nineveh province, 41006, Iraq AND Catholic University in Erbil, College of Pharmacy, Erbil, IraqFollow
Dr Mussalam L Alobaidy, Consultant surgeon and lecturer at Alnoor University – Iraq AND General Medical Council Associate and Examiner - United KingdomFollow
Dr Fawaz A. Alassaf, Assistant professor at the University of Mosul, College of Pharmacy, Department of Pharmacology and Toxicology, Mosul, Nineveh province, 41002, IraqFollow
Dr Mohammed N. Abed, Assistant professor at the University of Mosul, College of Pharmacy, Department of Clinical Laboratory Sciences, Mosul, Nineveh province, 41002, IraqFollow

Abstract

Background and aim: Duodenal atresia (DoA) is a congenital condition that is characterized by complete or incomplete duodenal obstruction. This condition needs urgent surgical intervention that carries risks of postoperative complications especially in low-birth-weight babies and with associated comorbidities. The success rate of the surgical procedure was reported to be higher than 90%. This case study details a neonate’s clinical course reporting the challenge in the management of delayed stricture and malnutrition after the primary surgery.

Case presentation and results: A female neonate was born at 38 weeks of gestation with 2.6 kg weight. During the immediate postnatal period, she was presented with upper abdominal distention and bilious vomiting. Duodenal atresia was the diagnosis, prompting duodenoduodenostomy surgery. She was discharged five days later after tolerating oral feeds. However, few days later she was readmitted to the hospital because of recurrent vomiting, feeding intolerance, and weight loss then progressed to passage of dark bloody stool. She was resuscitated with intravenous fluids, antibiotics, and antiacids medications. She needed blood transfusion as her Hb level was dropped to 7 g/dL. Adjusted total parenteral nutrition (TPN) as per the body weight and biochemical profile was prescribed to improve the general condition. Water soluble contrast was performed which revealed a stricture at the site of the original pathology. Revision surgery was performed with the insertion of a nasojejunal tube to enhance early feeding distal to the anastomotic site. The baby had uneventful postoperative recovery and tolerated full oral feeds.

Conclusion: Despite the reported surgical success rate, this case illustrates delayed stricture formation. The nasojejunal tube enhanced the recovery and reduced potential postoperative risks due to malnutrition. Therefore, proactive monitoring and structured operative strategies can reduce morbidity and improve survival in neonates with postoperative complications.

First Page

26

Last Page

31

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Alnaser, Raniah I.; Alobaidy, Dr Mussalam L; Alassaf, Dr Fawaz A.; and Abed, Dr Mohammed N. (2026) "Postoperative Duodenal Stricture in a Neonate with Duodenal Atresia – Innovative Approach and Lessons Learned," BioMed Visions Journal: Vol. 2: Iss. 1, Article 4.
DOI: https://doi.org/10.63100/3078-6738.1015