ABSTRACT

STENOSIS DUODENUM ET CAUSA MIDGUT MALROTATION WITH

LADDS BAND PROCEDURE

Background
Duodenal stenosis is incomplete duodenal obstruction due to failure to form billiard and
pancreatic structures or malrotation of the digestive system during fetal mass. Bowel obstruction
must be considered an emergency, because late diagnosis and management will provide a poor
prognosis and even death. The ladd procedure is the best management for malrotation cases

Objective
To illustrate a malrotation duodenum et causa midgut stenosis in children can be assessed
through history taking, physical examination, laboratory assessment, and radiography.

Methods
Radiology examination uses plain abdominal photographs, Ultrasonography, Upper
gastrointestinal series, Barium contrast, and CT Scan with contrast

Results
Boys aged 7 days were referred to RSWS with a diagnosis of Suspect Congenital Hypertrophy
Pyloric Stenosis. From alloanamnesis, patients often vomited green every +/- 3 hours after
being given milk. From physical examination, patients appear passive, anemic and jaundice.
Laboratory results obtained an increase in WBC. Ultrasound examination before entering
RSWS is within normal limits. Plain abdominal radiographs were obtained distended on the
stomach, examination of ulcer duodenography showed a picture of duodenal stenosis.
Laparatomy is then performed and a gastric and duodenal dilatation is obtained, the ligamentum
treitz is located in the right upper quadrant, band entrapment of the duodenum and mesenteric
artery, appendix and cecum located in the upper right, impression of Midgut Malrotation, Ladds
band procedure is decided. A week after surgery, symptoms of duodenal obstruction are
reduced and the patient appears more active

Discusion
The findings of duodenal stenosis due to band entrapment in recent years have often been
reported. Ladds band procedure is the best treatment option for this case. With the
advancement of imagin radiology, this condition can be found earlier even during antenatal
pregnancy.

Conclution
Duodenal stenosis is an emergency condition in the case of a tractus digestivus. Early diagnosis
and enforcement can provide a good prognosis.

Keywords : Green vomiting, band bondage, Radiology imaging, Ladd procedure