Abstract
A 16-month-old boy with intractable emesis was transferred to our institute. He had a history of occasional vomiting since infancy. A contrast study showed duodenal stenosis at the second portion of the duodenum. Endoscopy revealed a duodenal membrane with a small opening. The papilla of Vater was not identified proximal to the stenosis. The membrane was cloven open using a high-frequency wave cutter in two radiate directions and subsequent balloon dilatation (12 mm in diameter) was added uneventfully. Although he had been free from emesis with his regular diet, after 2 months vomiting recurred. Diamond shaped duodenoduodenostomy finally cured the child. Endoscopic strategy for congenital duodenal stenosis is controversial. We discussed pros and cons of endoscopic treatments for duodenal diaphragm with a review of the literature.
