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Purpose <p>Congenital duodenal diaphragm (CDD), a rare embryological anomaly resulting from incomplete recanalization of the fetal duodenum, represents a common cause of intestinal obstruction in neonates. This study evaluates the technical feasibility and clinical outcomes of endoscopic intervention with adjunctive balloon dilation for CDD management in neonates.</p> Methods <p>We retrospectively analyzed clinical data from two male neonates (3-day-old and 4-day-old) diagnosed with CDD at Anhui Children’s Hospital between January and April 2024. Both patients presented with postprandial non-bilious vomiting and characteristic imaging findings. Diagnosis was confirmed through endoscopic visualization of a circumferential membranous obstruction in the second portion of the duodenum.</p> Results <p>Endoscopic procedures comprised radial incision of the diaphragmatic membrane using an electrosurgical knife followed by controlled balloon dilation (8–10&#xa0;mm diameter). Technical success was achieved in both cases, with immediate resolution of obstructive symptoms. No perioperative complications, including hemorrhage or perforation, were observed. At 3-month follow-up, both patients demonstrated appropriate weight gain (25–30&#xa0;g/day) and maintained patent duodenal lumens on contrast studies.</p> Conclusion <p>This preliminary experience suggests that endoscopic management of CDD in neonates offers a safe, minimally invasive alternative to conventional laparotomy, with favorable short-term outcomes. The dual-modality approach combining endoscopic incision and balloon dilation appears effective for restoring duodenal patency while preserving anatomical integrity. Further multicenter studies with extended follow-up periods are warranted to validate these findings.</p>

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Endoscopic treatment of congenital duodenal diaphragm in neonates

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月23日

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  • Zhen Wang,
  • Pengfei Ma,
  • Wei Zuo,
  • Lin Li,
  • Ailing Chen,
  • Ya Wang,
  • Fang Deng

摘要

Purpose

Congenital duodenal diaphragm (CDD), a rare embryological anomaly resulting from incomplete recanalization of the fetal duodenum, represents a common cause of intestinal obstruction in neonates. This study evaluates the technical feasibility and clinical outcomes of endoscopic intervention with adjunctive balloon dilation for CDD management in neonates.

Methods

We retrospectively analyzed clinical data from two male neonates (3-day-old and 4-day-old) diagnosed with CDD at Anhui Children’s Hospital between January and April 2024. Both patients presented with postprandial non-bilious vomiting and characteristic imaging findings. Diagnosis was confirmed through endoscopic visualization of a circumferential membranous obstruction in the second portion of the duodenum.

Results

Endoscopic procedures comprised radial incision of the diaphragmatic membrane using an electrosurgical knife followed by controlled balloon dilation (8–10 mm diameter). Technical success was achieved in both cases, with immediate resolution of obstructive symptoms. No perioperative complications, including hemorrhage or perforation, were observed. At 3-month follow-up, both patients demonstrated appropriate weight gain (25–30 g/day) and maintained patent duodenal lumens on contrast studies.

Conclusion

This preliminary experience suggests that endoscopic management of CDD in neonates offers a safe, minimally invasive alternative to conventional laparotomy, with favorable short-term outcomes. The dual-modality approach combining endoscopic incision and balloon dilation appears effective for restoring duodenal patency while preserving anatomical integrity. Further multicenter studies with extended follow-up periods are warranted to validate these findings.