Neonatal Intestinal Obstruction Caused by a Perforated Duodenal Web

Aim: To report the clinical courses of two patients with intestinal obstruction caused by duodenal web, who were diagnosed this rare congenital anomaly at Clinical Hospital Center Rijeka in a span 5 months. Case report: One was prenatally suspected to have due ultrasonographic findings, while other showed signs not tolerating oral intake from second day life (DOL). Ceasing enteral feeding, placing nasogastric tube and introducing intravenous hydration parenteral nutrition performed as initial management. Abdominal ultrasonography, abdominal radiography, upper gastrointestinal contrast study enema but no obstruction. Both improvement over next few days. However, first patient did tolerate meals exceeding 15 mL infant formula, again any 15th life. A broad diagnostic workup repeated show conclusive evidence regarding patient. Esophagogastroduodenoscopy found unknown origin Laparotomy on 19th 25th DOL, respectively. Duodenal web visualized excised both following duodenotomy. Postoperative recovery orderly minor nonsurgical complications. The discharged hospital 21st 36th postoperative day, Conclusions: Diagnosing perforated is often challenging because possible intermittent nature its symptoms. Exploratory laparotomy sometimes required reach diagnosis.