>Year 2001, Issue 3
Perales CJA, Paulín CE
Congenital duodenal membrane in the adult. Report on one case
Cir Gen 2001; 23 (3)
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Objective: To report the case of an adult female patient with gastric outflow obstruction syndrome due to the presence of a congenital, incomplete, dudodenal membrane treated with excision and duodenoplasty Heineke-Mickulicz type.
Design: Case report.
Setting: Private praxis.
Description of the case: A 35 years old woman with postprandial sensation of abdominal fullness of one week of evolution, intermittent epigastric pain, pyrosis, and vomiting of food ingested the day before, suggestive of gastric outflow obstruction. Endoscopy revealed erosive G-I esophagitis, dilated stomach with abundant food. Immediately before the duodenal angle, an important reduction in the lumen due to a circumferential membrane that reduced the diameter to 5 mm with fibrin exudates on its borders was observed. Biopsies were made from the borders of the stenosis. The esophagogastroduodenal series revealed gastric dilation and partial postbulbar stenosis. The patient was treated medically with rabeprazole and cisapride for 2 weeks until she was subjected to medial laparotomy. Duodenoplasty Heineke-Mickulicz type with excision of the stenotic concentric ring in the postbulbar region was performed. The patient was discharged from the hospital on the 6th day after surgery. The endoscopic and radiological monitoring after 8 months revealed free intestinal transit.
Conclusion: Congenital duodenal membrane as cause of high intestinal obstruction is not frequent in the adult. The early surgical treatment through excision and simple duodenoplasty remain the treatment of choice in non-complicated cases.
||Congenital duodenal membrane, duodenoplasty.
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>Year 2001, Issue 3