Table 1 Summary of rare cases of double alimentary tract obstruction due to congenital anomalies
Study | Authors’ study | Davidson, et al. (2015) [6] | Shah, et al. (2019) [7] | Naidu, et al. (2021) [8] | Chen, et al. (2014) [9] | Chen, et al. (2014) [9] | Ladan, et al. (2023) [10] |
|---|---|---|---|---|---|---|---|
Age at onset | Since birth (born at GA 41 weeks) | 15 years old | 10 days old | GA 31 weeks (born at GA 35 weeks) | 10 days old | Since birth (one of preterm twins born at GA 32 weeks) | Since birth (born at GA 38 weeks) |
Sex | Male | Female | Female | Male | Female | Female | Female |
Race | Thai | English | Indian | Malaysian | Taiwanese | Taiwanese | Middle-eastern |
Symptom and sign | Emesis/reflux (dysphagia lusoria), intermittent abdominal distension, no constipation | Acute abdominal pain, emesis, abdominal distension, obstipation, pigmentation on the buccal mucosa | Abdominal distension, constipation | Dilated stomach and bowel with polyhydramnios on prenatal ultrasonography at GA 31 weeks | Abdominal distension, emesis | Abdominal distension, constipation | Failure of passing meconium within the first 48 h, abdominal distension, constipation, bilious emesis |
Diagnosis | 1. Retroesophageal right subclavian artery 2. Congenital colonic stenosis 3. Idiopathic intracerebral hemorrhage with obstructive hydrocephalus | 1. Double-site intussusceptions due to two hamartomatous polyps 2. Peutz-Jeghers syndrome (STK11/LKB1 mutation) | Double congenital colonic stenosis | Double small intestinal atresia | Double small and large intestinal atresia | Double colonic atresia | 1. Colonic atresia 2. Hirschsprung disease |
Age at diagnosis | 1 & 2 After death 3. GA 40 weeks (by prenatal ultrasonography) | 1. 5 days after the onset 2. In the same admission | 1 month old | GA 31 weeks | 2 months old | 2 months old | 1. 3 days old 2. 7 days old ( 3 days after the first surgery) |
Sites of double alimentary tract obstruction | 1. Esophagus 2. Distal transverse colon to proximal sigmoid colon | 1.1 Mid jejunum 1.2 Distal ileum | 1. Descending-sigmoid junction 2. Sigmoid colon | 1. Second part of duodenum 2. Duodenojejunal junction | 1. Terminal ileum 2. Splenic flexure | 1. Hepatic flexure 2. Splenic flexure | 1. Splenic flexure 2. Distal colon |
Treatment | Blood transfusion, ventriculoperitoneal shunt and external ventricular drain (EVD) | Two small intestinal resections with primary anastomosis | Intestinal resection, end-to-end anastomosis, colostomy | Side-to-side duodenoduodenostomy, duodenojejunostomy | Enterocolostomy, colonic anastomosis | Two-stage surgery: 1. Colostomy at 4 months old 2. Colectomy with end-to-end anastomosis at 6 months old | 1. Colectomy with end-to-end anastomosis; at 4 days old 2. Soave pull-through surgery; at 41 days old |
Outcome | Died at 7 months old due to brain abscess from an infected EVD | Discharged in good condition | Discharged in good condition | Discharged in good condition | Discharged in good condition | Discharged in good condition | Died at 45 days old due to seizure and sepsis |