Cir Pediatr

. 2022 Jan 1;35(1):31-35. doi: 10.54847/cp.2022.01.16. https://pubmed.ncbi.nlm.nih.gov/35037438/

Duodenal atresia with apple peel associated with congenital diaphragmatic hernia: an exceptional case and a literature review

[Article in English, Spanish]J A Molino Gahete ¹, S López Fernández ¹, B Oliver ¹, H Boix ¹, O Rocha ¹, M López ¹, G Guillén ¹Affiliations expand

• PMID: 35037438
• DOI: 10.54847/cp.2022.01.16

Free article

Abstract in English, Spanish

Introduction: Duodenal atresia associated with apple peel is extremely rare. Duodenal atresia occurs as a result of absence of recanalization at an early stage, whereas intestinal atresia is seemingly due to vascular causes at later stages. The presence of abnormalities associated with diaphragmatic hernia is frequent, but association with duodenal atresia has been little explored.

Case report: This is the case of a female neonate born at gestational week 31, with duodenal atresia and apple peel, associated with left diaphragmatic hernia and major heart disease. An abdominal muscle flap was performed for diaphragmatic defect closure purposes, and duodenojejunal anastomosis was carried out following resection of part of the non-viable apple peel.

Discussion: To our knowledge, this is the first case described with this rare association. The combination of duodenal atresia and apple peel had been previously described 11 times. However, the association of both with congenital diaphragmatic hernia had not been reported yet.

Keywords: Apple peel; Congenital diaphragmatic hernia; Congenital malformation; Duodenal atresia; Intestinal atresia.