DUODENAL ATRESIA ASSOCIATED WITH ANNULAR PANCREAS IN A PATIENT WITH DOWN SYNDROME: CASE REPORT IN A PUBLIC HOSPITAL IN THE STATE OF GOIÁS (Atena Editora)

Abstract

Duodenal atresia is a congenital disorder that corresponds to the most common cause of intestinal obstruction in newborns. This relationship is even more present in patients with trisomy 21, who can also suffer from other malformations related to the gastrointestinal tract, such as annular pancreas. Infants who present with duodenal atresia commonly present with abdominal distension, dietary intolerance and vomiting in the first hours of life. The suspected diagnosis can be initiated prenatally with ultrasounds (USG), but confirmation usually occurs in the postnatal period through visualization of the “double bubble” sign on a simple abdominal x-ray. The treatment of this condition is surgical, with duodenoduodenostomy usually being performed to divert intestinal transit and correct the obstruction. This is a case report of duodenal atresia associated with annular pancreas in a patient diagnosed with Down syndrome. The case discussion was based on 12 articles selected from the Pubmed, Scielo, UpToDate and VHL databases. The study is descriptive and analytical, exploring the characteristics observed in the case report and related to the literature description. The report is of a male neonate, born by cesarean section with 35 weeks and 4 days of gestational age due to Doppler flowmetry suggesting zero diastole. During prenatal care, a morphological USG had already been performed, showing a double bubble sign, which is why an oroenteral tube was introduced in the delivery room, with good progression. The newborn (NB) presented typical facial features, with an oblique palpebral fissure, flat face and depressed nasal bridge. On the second day of life he developed bilious vomiting. Imaging tests showed a double bubble sign and genetic evaluation revealed a karyotype of 47 The patient evolved with good acceptance of the oral diet and was discharged after 37 days of life with good weight gain.