Congenital duodenal obstruction is known to occur most frequently at the second portion of duodenum where biliary tract and pancreatic duct terminate, and also known that membranous obstruction is common. In our series of eleven cases of congenital duodenal membranous stenosis, orifice of the ampulla opened just on the membrane in 4 cases and immediately above or below the membrane in 2 cases. In surgical correction of this disorder, we consider, exicsion of the membrane combined with duodenoplasty is coming to an usual procedure. Then, the recognition of the intimate reration-ship between the membrane and the ampulla may prevent inadvertent injuries to the ampulla. In one case, we were obliged to perform papilloplasty because of the injury of the ampulla at the resection of the membrane. Intravenous secretin injection, which induces an excretion of pancreatic juice from the ampulla, should be recommended as an alternative and effective trial for the recognition of the ampulla.
