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Dual duodenojejunostomies in the repair of megaduodenum, duodenal stenosis and prior missed diagnosis of annular pancreas
  1. Lily Ye Chen1,
  2. Victor F Cabrera-Bou1,2 and
  3. Adela T Casas-Melley1,2
  1. 1University of Central Florida College of Medicine, Orlando, Florida, USA
  2. 2Department of Surgery, Nemours Children's Hospital, Orlando, Florida, USA
  1. Correspondence to Lily Ye Chen; Lchen639{at}


Duodenal stenosis and atresia are some of the most common forms of congenital bowel obstruction. The gold standard approach to treatment is duodenoduodenostomy, while rare, gastrojejunostomy and duodenojejunostomies may still be used. We report a case of a 7-year-old male presenting with annular pancreas with duodenal stenosis that was diagnosed at birth as primary duodenal atresia and repaired by gastrojejunostomy with a Braun enteroenterostomy. Through successful reoperation with dual duodenojejunostomy and subsequent management, we treated the sequelae of the initial repair, including megaduodenum. Regions of duodenal obstruction must have direct anastomotic repair to prevent subsequent issues related to dysmotility. Otherwise, further surgical intervention and long-term medical management, such as the novel strategy reported, may be necessary.

  • stomach and duodenum
  • failure to thrive
  • gastrointestinal surgery
  • paediatric Surgery
  • general surgery

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  • Contributors LYC was the lead writer of the manuscript and was actively involved in patient care. VFC-B contributed to the manuscript writing and editing and was actively involved in decision-making and patient treatment. ATC-M was the surgeon in charge of patient treatment and was actively involved in writing and editing of the manuscript. All authors have read, edited and authorised the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.