Pediatric Surgery International

, Volume 35, Issue 1, pp 151–157 | Cite as

Duodenal atresia and associated intestinal atresia: a cohort study and review of the literature

  • Maria Enrica Miscia
  • Giuseppe Lauriti
  • Pierluigi Lelli Chiesa
  • Augusto ZaniEmail author
Original Article



To determine the true incidence of associated intestinal atresia (AIA) in infants with duodenal atresia (DA) and to analyze whether the surgical approach, open versus laparoscopic, would impact on patient outcome when AIA is present.


Cohort study We review all DA infants treated at our institution (2001–2016) and analyzed the outcome of those with AIA. Systematic review/meta-analysis Using a defined search strategy and according to PRISMA guidelines, two investigators independently identified all studies on DA and searched cases of AIA to determine its incidence. Data are mean ± SD.


Cohort study Of 140 DA infants, 10 (7%) had AIA (4 type I, 4 type III, 2 type II). All type I AIA (webs) were found in the duodenum. Systematic review/meta-analysis Of 840 studies, 18 were included (2026 infants). The incidence of AIA was 2.8 ± 1.6%. The incidence of missed AIA was 0.8 ± 2.4%. Three comparative studies (759 infants) showed higher risk of missed AIA following laparoscopic (2.9 ± 2.4%) than open repair (0.3 ± 0.1%; p < 0.01).


The incidence of AIA in DA infants is low and the risk of missing it is higher at laparoscopy than at laparotomy. Regardless the approach, surgeons should carefully investigate bowel continuity to avoid the risk of missing AIA.


Jejunal atresia Ileal atresia Cohort study Systematic review Meta-analysis 



This study was not funded by any grant.

Compliance with ethical standards

Conflict of interest

Authors have no potential conflicts of interest for this study.

Ethical approval

Ethical approval REB #1000055682. Not applicable in the Systematic Review and Meta-Analysis.

Informed consent

Not applicable, since the study was a review of the medical charts of patients, plus a Systematic Review and Meta-Analysis.

Supplementary material

383_2018_4387_MOESM1_ESM.docx (29 kb)
Supplementary material 1 (DOCX 29 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Maria Enrica Miscia
    • 1
    • 2
    • 3
  • Giuseppe Lauriti
    • 2
    • 3
  • Pierluigi Lelli Chiesa
    • 2
    • 3
  • Augusto Zani
    • 1
    Email author
  1. 1.Division of General and Thoracic SurgeryThe Hospital for Sick ChildrenTorontoCanada
  2. 2.Department of Pediatric Surgery“Spirito Santo” HospitalPescaraItaly
  3. 3.“G. d’Annunzio” University, Chieti-PescaraChietiItaly

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