Duodenal

Obstruction in a Newborn to a Multicystic Kidney By Garland

Duodenal

obstruction

N. Porterfield

in the nc~~natal

~x~mmonl~

reported

cause:,

hem,lt~~ma,

annular

pancreas.

duodenal

the right

kidnq

arter!.’

’ Although

secondary to extrinsic

of

pcrlod

rstrinhlc

compresson

and

can

duodenal

A 1741) e. 3 da) old premature :I hlator\

01‘ hllr

weight IOLI\. Ph\\ical revealed

ohqtruction

p3rti31

duodenum

(I-lg.

Icl’t hldnc!.

Renal

(tklg.2).

scnn u:i\

The patlent underwent p:lrtial extrinsic

consi\tent

upper quadrant

incisIc)n. The

extrin

1. barium

Upper

There

mesentcrli obstructior

This case report

Upper at

right

and rcve:llcd diafnosl\

kidney

~3s

showing duode-

““In.

Journal of Pediatric Surgery, Vol. 12, No 5 (October), 1977

lesionr.

mass in the second

kidney

part with

:Ln cihaence of

()I’ right multicystic

multiqatic

with

01’ the

rleht

rcn.il

kldnq

~cnd

LL right

3 single ureter.

nrphrcctom\i

rlglir \cr~:z

a normal

through

cyst\. The left kidney A right

Hospiiil

3 concom~t;~n~

gastrointehtlnnl

cavity was entered

hy the supcrlor

or intrlnslc

the

right

Memorial ~3s

nontender

comprcsslon

The perltuneal

gastrointesof

l’or :I tirm.

the I.V.P.

(t lg. 3).

series

lsic obstruction

c~idrnce

Children’s

since hlrth.

were normal.

eutrinslc

with

duodenal

m1~.1

du~~denal

the superior

the duodenum,

n of the duodenum.

second p;lrt \I)(‘ the duodenum

tinal

pylogram

from

The

bands.

ohrtructlon.

vomiting

normal

xcondxrq

extrlnslc.

mash has never been reported.

d3t:i and chrqt x-ray

I). Intravenous

p;lrcnch~ma

uas

or

congenital

REPORT

postpr3ndlal

euamlnati~,n

All Irlhoratory

art

l’cm;~lc W;IS rcl’crred IO Oklahom;i

staIned.

upper quxdrnnt.

intrinsic

pressure

and behind

~‘111dell Nith huch ;I wre CLIU’ICol’e~1rins1c duodenal

with

he either

dupllclrtion.

CASE

P. Campbell

ohatructlon

IFS directly

from 3 kidney

David

Secondary

Tic

was n(lrmlll und urcterci’-

PORTERFIELD

768

AND CAMPBELL

Fig. 2. Renal scan demonstrating sence of right kidney, Left kidney bladder with radioisotope.

The specimen was an irregular individual

cysts measured

shaped structure

0.2-2.7

composed

cm. All cysts contained

of thin-walled

oband

tan to gray cysts. The

a clear tan fluId.

Sectioning

revealed

absence of renal parenchyma. The postoperative function

and oral

hospitalized of2400

course was wlthout feeding& were begun

because of her prematurity

complication.

There

on the

postoperative

third

and was discharged

g. When seen one month after discharge,

the patient

was a rapid return day.

The

of normal patient

on the 29th hospital

bowl

remained

day at a weight

was doing well with a normal

weight

gain. and there was no further vomiting.

COMMENT The usual causes of extrinsic duodenal

obstruction

reported

obstruction

superior mesenteric artery compression, tion.

Harberg

and

have been mentioned.

Of 64 neonates

with extrinsic

by Wayne

Biggs.3 rn their

and Burrington,’ 6l”,, had congenital bands, 23”,, had 4”,, had annular pancreas, and 3”,, had duodenal duplica-

series also reported

congenital

bands

as the

most

com-

mon etiology. Other reported

rare causes of extrinsic 3 cases of duodenal

was a duplication choledochal Unilateral therefore

duodenal

obstruction

cyst and the other

obstruction

secondary

have

been reported.

Grynszpan

to pressure from an adjacent

two pancreatic

pseudocysts.

Obstruction

et al.J

cystic mass. One secondary

to a

cyst has also been reported.’ multicystic

kidney

is the most common

seems unusual that duodenal

obstruction

cause of abdominal

mass in the neonate.”

secondary to compression

It

by such a mass lesion.

DUODENAL

Fig. 3. kidney.

OBSTRUCTION

Extirpated

multicystic

REFERENCES I.

Wayne

tR.

ofY7 children Sure 107:X57 duodenal

tR.

Arch

in

JI):

children

C;ryns/pan

Duodenal

A,

obstruction

J Can Aswc

Bryk

D.

Surg

Gyn

duode-

509, 1963

6

Holder

Puchacxvskg

134, 1974

book pp

cau\;c:, Coil

(>I

Surge 01

of

TM. D

Leap (cd):

Surgery.

LL: Pedlatrlc

Davis

chap

Christopher

3X.

Saunders.

\urgrr!. Tc\r1’472.

I 166 I703

R:

caused by cystic masses.

RadIoI 25:13l

Congenital J Royal

1X:11)7 20X. lY73

In Sablston

Am Surg 29:506

AW:

ohstruciron.

Extrinsic

FJ, Biggs TM: Congenital

nxl oh\tructlon.

WIlkInson

duodenal tdinhurgh

BurrIngton

oh~tructlon

5

Management

obstructton.

136:X7 91. 1973

3. Harherg

1.

JD:

duodenul

X60. 1973

2. Wayne Obstet

BurrIngton

sith

7. Are!

JB: Ckstlc

Infant> and children.

lesion\ J Prdiatr

of the kidney

in

54:4?Y 115. IYi’j