A rare case of duodenal atresia with severe gastric bleeding, treated by vagotomy

Abstract

to the operating room. In the operating room, due to severe bleeding and hypotension, with great effort by the anesthesiologist, the infant was intubated and subsequently, the infant underwent gastrotomy and blood clots were removed. There was oozing of blood from the mucosal surface. Then, duodenodenodenostomy surgery was performed, which continued after bleeding into the stomach, so in these conditions, several solutions such as total gastrectomy, pacing, and vagotomy were proposed. The infant underwent anterior-posterior truncal vagotomy. Gastric bleeding was controlled immediately after vagotomy. Because vagotomy can cause the pyloric constriction, gastrojejunostomy is also performed on the baby. The infant was discharged in good general condition without any complications after spending time in the neonatal intensive care unit. Conclusion: Severe gastrointestinal bleeding is a very rare occurrence in duodenal atresia. In this situation, a gastrectomy can be considered and performed, which will be associated with many problems in the future. In adults, a vagotomy with a vascular contraction mechanism is used to control gastric bleeding. However, no case has been reported in the control of gastrointestinal bleeding in infants. In this case, for the first time, neonatal vagotomy was performed despite special technical subtleties, which was also accompanied by excellent therapeutic results.