Duodenal Atresia or Stenosis

A prospective, national observational study to assess the incidence, current management practices and outcomes of infants born with duodenal atresia or stenosis in the UK and Ireland.

Key Points

  • Contemporary information about the incidence of live-born infants with duodenal atresia or stenosis is limited
  • Variation in practice exists in both intra-operative and post-operative management
  • This study will provide a national picture of the incidence of live-born duodenal atresia or stenosis, its associated abnormalities, management and outcomes

Surveillance Period

March 2016 – March 2017

Aims

  • To estimate the incidence of infants live-born with duodenal atresia or stenosis in the UK and Ireland
  • To describe the current management of infants with duodenal atresia or stenosis born in the UK and Ireland
  • To assess the impact of current management practices on key outcomes
  • To inform plans for further research into the management of this condition

Objective

To determine the number of infants live-born with duodenal atresia or stenosis in the UK and Ireland, assess their burden of co-morbidities and describe their management and outcomes to 28 days and one-year post-operatively.

Research Questions

  • What is the current incidence of live-born duodenal-atresia or stenosis in the UK and Ireland?
  • How are these infants managed?
  • What is the incidence of associated abnormalities in live-born infants?
  • What is the impact of comorbidity on outcome?
  • What are the outcomes for infants managed with or without a trans-anastomotic feeding tube?
  • What are the outcomes for infants managed with or without a parenteral nutrition
  • What are the outcomes following different surgical techniques for repair of duodenal atresia or stenosis?

Case Definition

Any live-born infant with occlusion or narrowing of the duodenum associated with atresia, stenosis, duodenal web or annular pancreas presenting before 44 weeks post-conception.

Excluded: Occlusion of the duodenum caused by congenital bands associated with malrotation, intestinal volvulus, duplication cyst or malignancy.

Methods

Prospective multicentre descriptive study using the established British Association of Paediatric Surgeons Congenital Anomaly Surveillance System (BAPS-CASS).

Ethics Approval

The study has been approved by the NRES Committee South Central-Oxford A (Ref: 12/SC/0416)

Study Team

Mr Nigel Hall, Associate Professor of Paediatric Surgery, University of Southampton

Ms Anna-May Long, Clinical Research Fellow in Paediatric Surgery, NPEU

Professor Marian Knight, Professor of Maternal and Child Population Health