Abstract
The patient was a 0-day-old boy. At 29 weeks of gestational age, jejunal atresia was suspected because of the findings of hydramnion and the triple bubble sign in fetal ultrasonography. The patient was born at 35 weeks of gestational age, with a weight of 2,090 g, via normal vaginal delivery. Abdominal X-ray showed the triple bubble sign, and gastrointestinal contrast enema series showed malrotation and a non-contrasted cyst beneath the duodenal bulb. An abdominal plane computed tomography showed no relationship of the cyst with the liver and bile duct. We preoperatively diagnosed the patient as having congenital duodenal stenosis and congenital duodenal atresia and malrotation. A laparotomy revealed that the malrotation and duodenal stenosis were due to annular pancreas and type II duodenal atresia 5 cm distal to the stenotic lesion, both in the second portion of the duodenum. Ladd’s procedure and double duodeno-duodenotomy with the placement of a trans-anastomotic tube were performed. The post-operative course was uneventful, and the patient was discharged at 42 days of age.
