SEARCH FOR ASSOCIATED ANOMALIES!
Normal or scaphoid abdomen is obs is proximal!
FIRST OF ALL, RESUSCITATE AND DECOMPRESSION
ITS DANGEROUS!!! WHY??
close proximity to the ampulla of vater & pancreatic blood supply.
Rx: DUODENODUODENOSTOMY AND DUODENOJEJUNOSTOMY. IF THERE IS MALROT- LADDS PROCEDURE
we can also do DIAMON SHAPED ANASTOMOSIS BECAUSE THE DIAMETER OF THE PROXIMAL AND DISTAL PART TO THE OBSTRUCTION IS NOT PROPORTIANATE.
In duodenal web, do DUODENOTOMY. BE CAREFUL OF OTHER DEFECTS AND AMPULLA OF VATER.
About ladds band(excerpt from emedicine)
abnormal cecal peritoneal bands that cross over the duodenum in the right upper quadrant may be found in cases of malrotation. These abnormal cecal attachments are called Ladd bands. In both nonrotation and incomplete rotation, cecal bands may cause obstruction and ischemia before birth, leading to congenital duodenal atresia or stenosis
In many cases, the abnormal Ladd bands cause only partial and intermittent obstruction, which can manifest as intermittent episodes of bilious vomiting and/or feeding intolerance.