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Incidentally Diagnosed Duodenal Web in Infancy

영아기에 우연히 진단된 십이지장 격막

  • Suh Young Kim (Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Byoung Hee Han (Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Ki Young Park (Department of Pediatrics, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Jung-Man Namgoong (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Da Hee Woo (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 김서영 (울산대학교 의과대학 강릉아산병원 영상의학과) ;
  • 한병희 (울산대학교 의과대학 강릉아산병원 영상의학과) ;
  • 박기영 (울산대학교 의과대학 강릉아산병원 소아청소년과) ;
  • 남궁정만 (울산대학교 의과대학 서울아산병원 외과) ;
  • 우다희 (울산대학교 의과대학 서울아산병원 외과)
  • Received : 2021.03.21
  • Accepted : 2022.01.02
  • Published : 2022.05.01

Abstract

A duodenal web is an incomplete diaphragm of the duodenal lumen that causes a partial or (intermittent) complete obstruction. The size of a duodenal web's aperture determines the degree of obstruction, age at presentation, and radiologic findings. We report a case of duodenal web incidentally diagnosed in a 14-month-old boy who presented to the hospital after ingesting a foreign body. We provide a comprehensive report of multiple studies through abdominal radiograph, upper gastrointestinal study, endoscopy, and surgical findings. We emphasize that the duodenum should be considered as the location of the obstruction when infants exhibit delayed discharge or dynamic positioning of a foreign body in a radiologic examination.

십이지장 격막은 십이지장 관강 내의 불완전한 막으로 부분폐쇄 또는 간헐적인 완전 폐쇄를 일으킨다. 격막의 개구부 크기에 따라 폐쇄의 정도, 증상이 나타나는 시기, 영상의학적 소견이 다르다. 저자들은 이물질 섭취를 주소로 내원한 14개월 남아에서 우연히 진단된 십이지장 격막 증례를 보고하고자 한다. 복부 방사선 촬영, 상부 위장관조영술, 내시경, 수술 소견들을 종합하여 기술하였다. 저자들은 영아기에 섭취한 이물질의 배출이 지연되고 영상의학적 검사에서 이물질의 위치가 다양하게 변화할 경우, 폐쇄 위치로 십이지장을 고려해야 한다는 사실을 강조한다.

Keywords

References

  1. AlGhannam R, Yousef YA. Delayed presentation of a duodenal web. J Pediatr Surg Case Rep 2015;3:530-533
  2. Kimura K, Loening-Baucke V. Bilious vomiting in the newborn: rapid diagnosis of intestinal obstruction. Am Fam Physician 2000;61:2791-2798
  3. Mulholland MW, Lillemoe KD, Doherty GM, Upchurch GR, Alam H, Pawlik TM. Greenfield's surgery : scientific principles & practice. 6th ed. Philadelphia: Wolters Kluwer 2017:5624-5625
  4. Mousavi SA, Karami H, Saneian H. Congenital duodenal obstruction with delayed presentation: seven years of experience. Arch Med Sci 2016;12:1023-1027
  5. Gupta P, Debi U, Sinha SK, Prasad KK. Upper gastrointestinal barium evaluation of duodenal pathology: a pictorial review. World J Radiol 2014;6:613-618
  6. Cho HH, Lee SM, You SK. Gastrointestinal emergencies in neonates: what we should know. J Korean Soc Radiol 2020;81:770-793
  7. Yeom HH, Kwon KB, Park KB, Park JS, Park JO, Kim YT. A case of incomplete congenital duodenal diaphragm presented as hematemesis. Korean J Pediatr Gastroenterol Nutr 2005;8:64-69
  8. Traubici J. The double bubble sign. Radiology 2001;220:463-464