All issues > Volume 16(10); 1973

Case Report

J Korean Pediatr Soc. 1973;16(10):758-762. Published online October 31, 1973.

A Case of Duodenal Stenosis Associated with Down’s Syndrome

Jin Yung Ro¹, Eui Hyun Jo¹, Dong Won Chun¹, Sang Jhoo Lee¹

¹Department of Pediatrics, College of Medicine, Kyung Hee University Seoul, Korea

Abstract

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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