| A Case of Duodenal Stenosis Associated with Down’s Syndrome |
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Jin Yung Ro, Eui Hyun Jo, Dong Won Chun, Sang Jhoo Lee |
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Department of Pediatrics, College of Medicine, Kyung Hee University Seoul, Korea |
| Down’s Syndrome 에 隨伴한 先天性 十二指腸 狹窄症의 1例 |
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盧鎭英, 曺義鉉, 全東源, 李尙柱 |
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慶熙大學校 醫科大學 小兒科學敎室 |
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| Abstract |
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We had a case of severe duodenal stenosis associated with Down’s syndrome, a 3 day old female infant who was admitted to our Kyung Hee Medical Center with chief compliant of projectile vomiting and fever. On physical examination she had a typical monogloid appearance such as small head (circum. 29 cm) and head is flattened anteriorly and posteriorly, prominant epicanthal folds, lateral upward slope of the eyes, flat nose bridge, protruded tongue, broad hands, shortness of 5 th fingers, wide space between the 1st and 2nd toes and hypotonia etc. Abdomen was moderately distended and peristaltic waves were seen and no bowel sound was audible. Laboratory examination showed 1+ bile and 4 4- occult blood in vomitus. X-ray of the simple abdomen revealed markedly dilated stomach and duodenum (double bubble appearance) and only small amount of gas was present beyond the obstruction. X-ray of the pelvis revealed small acetabular angles, which showed 18°. Upper G-I series revealed dilated duodenal bulb due to narrowing of the lumen and poor passing of the barium into the descending portion of duodenal loop. 12 hour film revealed poor passing of the barium into the small bowels and most of the barium was remaining in the stomach. On the basis of above findings severe duodenal stenosis associated with Down’s syndrome was made. Patient was advised to have operation but refused it and was discharged against advise. Review of literature was made briefly.
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