Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jun 16, 2024; 16(6): 343-349
Published online Jun 16, 2024. doi: 10.4253/wjge.v16.i6.343
Balloon dilation of congenital perforated duodenal web in newborns: Evaluation of short and long-term results
Kirill Marakhouski, Elena Malyshka, Katsiaryna Nikalayeva, Larysa Valiok, Aleh Pataleta, Kiryl Sanfirau, Aliaksandr Svirsky, Vasily Averin
Kirill Marakhouski, Division of Diagnostic, Republican Scientific and Practical Centre of Paediatric Surgery, Minsk 220113, Belarus
Elena Malyshka, Larysa Valiok, Department of Newborn Surgery, Republican Scientific and Practical Center of Pediatric Surgery, Minsk 220013, Belarus
Katsiaryna Nikalayeva, Aliaksandr Svirsky, Department of Pediatric Surgery, Republican Scientific and Practical Center of Pediatric Surgery, Minsk 220013, Belarus
Aleh Pataleta, Kiryl Sanfirau, Division of Diagnostic, Republican Scientific and Practical Center of Pediatric Surgery, Minsk 220013, Belarus
Vasily Averin, Academic Chair of Pediatric Surgery, Belarusian State Medical University, Minsk 220116, Belarus
Author contributions: Marakhouski K, Malyshka E, Nikalayeva K, and Valiok L collected literature data, analysed data; Marakhouski K and Malyshka E performed diagnostic tests and treated the patients; Marakhouski K, Pataleta A, and Sanfirau K performed diagnostic tests; Marakhouski K, Malyshka E, Pataleta A, Sanfirau K, Svirsky A, and Averin V contributed to the conception and design of the work; Malyshka E, Nikalayeva K, and Valiok L collected the patient’s clinical data; Marakhouski K, Nikalayeva K, Svirsky A, and Averin V structed the text and revised the paper, drafted the work, and revised it critically for important intellectual content; All authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Research Ethics Committee of Republican Scientific and Practical Center of Pediatric Surgery Minsk, Republic of Belarus (Protocol 9 of August 24, 2023).
Informed consent statement: All study participants or their legal guardian provided informed written consent prior to study enrolment.
Conflict-of-interest statement: We declare that there is not conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Katsiaryna Nikalayeva, BSc, Research Scientist, Department of Pediatric Surgery, Republican Scientific and Practical Center of Pediatric Surgery, Nezavisimosti ave 64A, Minsk 220013, Belarus. katekot1919@gmail.com
Received: January 10, 2024
Revised: February 23, 2024
Accepted: April 29, 2024
Published online: June 16, 2024
Processing time: 155 Days and 23.2 Hours
Abstract
BACKGROUND

Incomplete congenital duodenal obstruction (ICDO) is caused by a congenitally perforated duodenal web (CPDW). Currently, only six cases of balloon dilatation of the PDW in newborns have been described.

AIM

To present our experience of balloon dilatation of a perforated duodenal membrane in newborns with ICDO.

METHODS

Five newborns who underwent balloon dilatation of the CPDW along a preinstalled guidewire between 2021 and 2023 were included. Nineteen newborns diagnosed with ICDO who underwent laparotomy were included in the control group.

RESULTS

In all cases, good anatomical and clinical results were obtained. In three cases, a follow-up study was conducted after 1 year. The average time to start enteral feeding per os was significantly earlier in the study group (4.4 d) than in the laparotomic group (21.2 days; P < 0.0001). The time spent by patients in the intensive care unit and hospital after balloon dilatation was also significantly shorter. We determined the selection criteria for possible and effective CPDW balloon dilatation in newborns as follows: (1) Presence of dynamic radiographic signs of the passage of a radiopaque substance beyond the zone of narrowing or radiographic signs of pneumatisation of the duodenum and small bowel distal to the web; (2) presence of endoscopic signs of CPDW; (3) successful cannulation with a guidewire performed parallel to the endoscope, with holes in the congenital duodenal web; and (4) successful positioning of the balloon performed along a freestanding guidewire on the web.

CONCLUSION

Strictly following selection criteria for newborns with ICDO caused by CPDW ensures that endoscopic balloon dilatation using a pre-installed guidewire is safe and effective and shows good 1-year follow-up results.

Keywords: Newborns; Congenital duodenal obstruction; Perforated duodenal membrane; Endoscopy; Balloon dilation

Core Tip: Congenital perforated duodenal web is the most common cause of incomplete congenital duodenal obstruction (ICDO). The clinical picture of ICDO may be absent, leading to its late diagnosis. Since 1986, approximately 70 cases of endoscopic treatment of congenital perforated duodenal membrane have been described in the literature, with only 6 cases in newborns. This study presents five successful cases of endoscopic treatment of congenital perforated duodenal web in newborns, including their one-year follow-up outcomes.