We must carefully explore whether there are other congenital malformations during the operation, such as intestinal malrotation and annular pancreas. Normal saline should be injected into the distal end of atresia to dilate it, and all small intestines should be examined in turn for multiple atresia and stenosis. According to the deformity, choose the operation method, relieve the diaphragmatic atresia, and be careful to prevent damage to the common bile duct entrance. If the proximal and distal ends of the duodenum are quite close, or there is a circular pancreas at the same time, duodenal anastomosis can be performed. Duodenal jejunostomy can be selected for distal duodenal atresia and stenosis, but blind end syndrome may occur after operation. You can also use the method of cutting off the duodenum, and plastic and anastomose the expanded intestine by cutting off the duodenum, which can restore the effective peristalsis of the duodenum at an early stage, advance the date of eating and reduce complications.
Some people argue that gastrostomy can ensure gastric emptying and prevent aspiration, and the gastric tube can enter the jejunum through the anastomosis and eat as soon as possible. Catheter can also be placed in jejunum, and nutrient solution can be infused immediately after operation to promote rehabilitation.
The treatment of duodenal atresia is quite difficult, and the curative effect is still not ideal. The mortality rate is around 50%. The prognosis is related to the time of diagnosis, the degree of deformity, multiple atresia, severe combined malformation, premature delivery or low birth weight infants.