A Case of Duodenal Atresia With a Y-Shaped Bile Duct Complicated by High Anorectal Malformation

Abstract

The patient was a 0-year-old boy who was born at 36 weeks and 1 day of gestation and weighed 1,856 grams. There was no anus or fistula on the external surface of the perineum. On day 1, he was diagnosed as having high anorectal malformation on the basis of invertography findings and underwent colostomy. Postoperatively, he was able to drink milk; however, bilious vomiting was observed on day 8. An X-ray showed dilation of the stomach and the duodenum, and we diagnosed him as having duodenal stenosis on the basis of the findings of an upper gastrointestinal series. Reoperation was performed on day 14, and he was found to have duodenal atresia with a Y-shaped bile duct. In addition to duodenal atresia surgery, Ladd operation for intestinal malrotation and reconstruction of colostomy was performed. The patient did well after the operation. There are a number of cases of congenital duodenal atresia with traffic around the site of atresia by the Y-shaped bile duct. Even in neonates with small intestinal gas, the presence of duodenal atresia should be carefully evaluated before the operation.