Vol. 9, Issue 2, Part C (2025)

Background: Congenital duodenal obstruction is a common neonatal surgical condition that may result from intrinsic causes such as atresia, stenosis, or webs, or from extrinsic anomalies like annular pancreas and malrotation. Early diagnosis and appropriate surgical intervention are crucial to reduce morbidity and mortality, yet postoperative complications remain a challenge, particularly in preterm infants.

Aim: To analyze the clinical presentation, surgical management, and postoperative complications in neonates treated for congenital duodenal obstruction at the Central Teaching Hospital for Children in Baghdad.

Methods: A prospective observational study was conducted over one year (January 2014–January 2015) involving 25 neonates diagnosed with duodenal obstruction. Data included patient demographics, clinical presentation, radiological findings, operative procedures, and postoperative outcomes. Statistical analysis was performed using SPSS v20, with significance set at p<0.05.

Results: Among the 25 neonates (60% female, 40% male), 44% had duodenal atresia, 20% intrinsic web, 20% annular pancreas, and 16% malrotation. All presented with bile-stained vomiting. Duodenoduodenostomy was the most common surgical procedure (64%), followed by duodenotomy and Ladd’s procedure. Postoperative complications included prolonged feeding intolerance (44%), chest infection (16%), wound infection (16%), gastroesophageal reflux (12%), intestinal obstruction (8%), and one case (4%) of neonatal sepsis with mortality. Significant associations were found between prematurity and both feeding intolerance (p=0.009) and chest infection (p=0.016).

Conclusion: Duodenal atresia and stenosis are the predominant causes of congenital duodenal obstruction. Duodenoduodenostomy remains the standard treatment. Premature infants are more susceptible to postoperative complications, highlighting the need for vigilant perioperative care.