The late nonfunctioning duodenal atresia repair.

Since 1979, three newborn males had duodenoduodenostomies for duodenal atresia, and all babies had smooth uncomplicated postoperative courses. There were no other anomalies. Between 6 and 18 months postoperatively, each infant developed an obstruction at the anastomosis that was initially treated with prolonged nasogastric suction. Because conservative management did not relieve the obstruction, the first two babies were operated on several times with revision of the anastomosis and bypass procedures, all of which were slow to function and required prolonged intravenous alimentation. It then became apparent that the duodenoduodenostomy was functionally obstructed. Therefore, the third infant was successfully treated with plication only of the dilated atonic proximal duodenum. All three children are now thriving more than 2 years after their surgery.