Duodenal obstruction in Nigerian newborns and infants.

Experience with the management of congenital duodenal obstruction in a tropical environment is analysed with a view to highlighting some of the problems and suggesting solutions. 30 infants with duodenal obstruction were treated at the Lagos University Teaching Hospital between 1978 and 1985. 15 (50%) infants had duodenal atersia. 7 (23%) had Ladd's bands, 6 (20%) had duodenal diaphragm and there was one bay with partial duodenal obstruction caused by a duplication cyst. The associated abnormalities encountered in 7 infants are distal bowel atresia (3), partial situs inversus (3) and Trisomy 21 (1). Delay in presentation and inadequate facilities constituted the major constraints. 7 of the 25 infants that had corrective surgery died, a mortality of 28%. All the infants that were treated within the first 8 days of life survived. After this period survival was restricted to those with incomplete obstruction. Mortality can be reduced by the provision of adequate facilities and health education.