What is the surgical treatment for duodenal obstruction?

Updated: Dec 19, 2018
  • Author: Denis D Bensard, MD, FACS, FAAP; Chief Editor: Carmen Cuffari, MD  more...
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Answer

After the volvulus is reduced or if no volvulus was present, identify any extrinsic obstruction to the duodenum.

If peritoneal bands crossing the duodenum are found, ligate them with careful attention to protecting the superior mesenteric vessels. The bands may also obstruct the ileum or the jejunum and sometimes run to the gallbladder and liver.

Extrinsic obstruction may also be due to the cecum, colon, or superior mesenteric artery (SMA), impinging on the duodenum; relief is obtained by placing the cecum with its mesentery in the left upper quadrant and exposing the anterior duodenum through its entire length. After extrinsic obstruction has been relieved, determine that no intrinsic obstruction exists by passing an NG tube through the duodenum.


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