Is your newborn baby vomiting right after drinking milk? Is the vomit greenish-yellow? As a mother, it is normal to be very scared when you see something like this. But sometimes this can be due to a condition called 'Duodenal Atresia', which we are talking about today. Don't be scared when you hear this name. This is a condition that can be treated and completely cured. Let's talk about everything simply and clearly.
What is Duodenal Atresia?
Simply put, this means that there is a blockage at birth in the beginning of our baby's small intestine, that is, in a part of the duodenum. Think of it like a water pipe getting stuck in the middle. After the milk that the baby drinks goes into the stomach, it needs to go down the intestine to be digested. But because of this blockage, the milk and digestive juices cannot pass through there. That is why the baby vomits.
This is a congenital condition . This means that the problem occurs while the baby is still in the womb. Sometimes, babies with this condition may also have other health problems, such as heart disease or Down syndrome.
Although this is a serious condition, it can be treated very successfully if diagnosed and treated early. The most important thing is to get the baby medical attention as soon as possible.
Are there different types of this?
Yes, there are several main types of this blockage, depending on how it occurs. You don't need to worry too much about these, but it's good to know if your doctor talks about it.
| Type | Simply explained |
|---|---|
| Type 1 | The inside of the intestine is blocked by something like a thin membrane. Like a tube covered with a membrane. |
| Type 2 | The two parts of the intestine are separate, but connected by something like a string. |
| Type 3 | The two parts of the intestine are completely separate, with no connection between them. |
| Duodenal Stenosis | In this case, the intestine is not completely blocked, but that part has become very narrow, which hinders the movement of food. |
What are the symptoms of this condition?
It is very important to be aware of these characteristics.
Most of the time, these symptoms appear within the first few hours after the baby is born.
- Vomiting: This is the main symptom. It can occur after the baby is fed for the first time. This vomit can be green, yellow, or light brown in color . If left untreated, the vomiting will increase.
- Upper abdominal swelling: Due to a blockage in the intestine, food and fluid accumulate, making the upper abdomen appear bloated.
- Low birth weight.
- Constipation.
- Jaundice: Yellowing of the eyes and skin.
Sometimes, if the intestinal blockage is not complete (partial blockage), meaning only a small amount is blocked, these symptoms may appear in a baby after a few months or even during childhood.
Why is this happening? What is the reason?
This is actually the result of a very complex process. When a baby is growing in the womb, around 5-6 weeks, the duodenum first forms as a thick tube. Then, the cells inside that tube gradually die off, forming a hollow tube. This is called `(apoptosis)`.
If somehow these cells die and the process of forming an empty tube does not happen correctly, a blockage occurs. That is called Duodenal Atresia. If this process is not completed and stops halfway, conditions like Duodenal Stenosis (narrowing of the intestine) occur.
How do doctors diagnose this condition?
This condition can be diagnosed before or after the baby is born.
Prenatal Diagnosis
Scans during pregnancy can provide clues about this.
- Fetal Ultrasound: If during your routine scan, the doctor sees a "double bubble" in your baby's abdomen, meaning the stomach and the first part of the uterus are filled with fluid, this may be suspicious. Also, if there is an excessive amount of amniotic fluid around the baby (polyhydramnios), this can also be a sign of this condition. This is because the baby normally swallows some of this fluid, but is unable to do so because of a blockage in the intestines.
- Fetal MRI: If the scan is not clear, an MRI may sometimes be done.
If this is suspected, doctors may also recommend tests such as amniocentesis to check for chromosomal abnormalities such as Down syndrome.
After the baby is born (Postnatal Diagnosis)
This condition is definitively diagnosed only after the baby is born.
- Abdominal X-ray: An X-ray examination clearly shows the previously mentioned "double bubble sign." This means that the stomach and duodenum are filled with air, while the air in the intestines below is not visible.
- Barium Swallow Test: Sometimes, especially if the blockage is not complete, the baby is given a liquid called barium through a tube and an X-ray is taken to see exactly where and what the blockage is.
How is it treated? Can this be cured?
Yes, the only and most successful treatment for this condition is surgery .
Before surgery, the baby will not be given milk by mouth. Instead, the body will be given the necessary nutrition through a saline solution (IV). Also, a small tube will be inserted through the nose or mouth into the stomach to remove air and fluid that has accumulated in the baby's stomach.
Most of the time, the surgery is performed within two to three days of the baby being born.
Surgery
This surgery is called a duodeno-duodenostomy. It involves bypassing the blocked part of the intestine and connecting the healthy parts above and below it. It's like removing a blocked piece of pipe and inserting a new one.
With current technology, this surgery is often performed using a minimally invasive surgery method, where a camera is inserted through a few very small incisions, rather than making a large incision in the abdomen. This means that the baby recovers faster.
What happens after surgery?
After surgery, the baby is cared for in the neonatal intensive care unit (NICU). It may take a week or more for the intestines to start working normally again. Until then, the baby is fed through saline.
Once the intestines start working, you will gradually start giving milk. When the baby is drinking well and starting to gain weight, you can go home from the hospital. Usually, you have to stay in the hospital for about two to three weeks.
Is this situation dangerous? What should we think about the future?
If left untreated, this is very dangerous for the baby's life. However, the results after surgery are very good. The earlier the disease is diagnosed and the sooner treatment is given, the better the results.
There is no way to prevent this condition yet. So never think that it is your fault. The most important thing is that if you know about it during pregnancy, the doctors can be prepared to give the necessary treatment when the baby is born. Therefore, it is very important to follow proper medical advice.
If your baby has this condition, talk to your doctor and explain everything. Don't worry, the medical team will provide all the help you and your baby need.
Take-Home Message
- Duodenal atresia is a birth defect that occurs in the first part of a newborn's small intestine.
- The main symptom is vomiting, especially green or yellow, after drinking milk.
- This can be detected through scans during pregnancy or through an X-ray examination after the baby is born.
- The treatment is surgical, and the results are very successful.
- If your baby has these symptoms, don't panic or delay, but see a doctor immediately. Prompt treatment can help your baby recover completely.
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