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Pediatrics
Diagnosis
Gastrointestinal
Neonatal Upper Intestinal Obstructions
Duodenal Web
Duodenal Web
Steven J. Kraus, MD; A. Carlson Merrow, Jr., MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Incomplete diaphragm of duodenal lumen causing high-grade duodenal obstruction
              • Duodenal atresia (DA) spectrum but with later clinical presentation

            IMAGING

            • General Features

              • Radiographic Findings

                • Fluoroscopic Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Treatment

                                Selected References

                                1. Tsitsiou Y et al: Diagnostic decision-making tool for imaging term neonatal bowel obstruction. Clin Radiol. 76(3):163-71, 2021
                                2. Medscape: Intestinal Atresia, Stenosis, and Webs. Duodenal Stenosis and Atresia. Updated 19, 2021. Accessed July 4, 2021. http://emedicine.medscape.com/article/940615-overview, Intestinal Atresia, Stenosis, & Webs
                                3. Hameed S et al: The role of sonography in differentiating congenital intrinsic duodenal anomalies from midgut malrotation: emphasizing the new signs of duodenal and gastric wall thickening and hyperechogenicity. Pediatr Radiol. 50(5):673683, 2020
                                4. Wettasinghe MC et al: Gastroduodenal emphysema with portal venous air due to congenital duodenal web in a child: a case report and review of literature. Case Rep Pediatr. 2020:9897208, 2020
                                5. Tu LH et al: Duodenal intussusception secondary to web presenting as recurrent pancreatitis in a 7-year-old girl. Pediatr Radiol. 46(3):426-9, 2016
                                6. Wood LS et al: Endoscopic division of duodenal web causing near obstruction in 2-year-old with trisomy 21. J Laparoendosc Adv Surg Tech A. 26(5):413-7, 2016
                                7. Eksarko P et al: Duodenal web associated with malrotation and review of literature. J Surg Case Rep. 2013(12), 2013
                                8. Muensterer OJ et al: Resection of a duodenal web using single-incision pediatric endosurgery. J Pediatr Surg. 46(5):989-93, 2011
                                9. Melek M et al: Two cases of duodenal obstruction due to a congenital web. World J Gastroenterol. 14(8):1305-7, 2008
                                10. Mustafawi AR et al: Congenital duodenal obstruction in children: a decade's experience. Eur J Pediatr Surg. 18(2):93-7, 2008
                                11. Fisher JC et al: Gastric outlet obstruction as a consequence of a duodenal web masquerading as gastrinoma in an adult. Curr Surg. 60(6):602-6, 2003
                                12. Yoon CH et al: Sonographic windsock sign of a duodenal web. Pediatr Radiol. 31(12):856-7, 2001
                                13. Adebamowo CA et al: Duodenal web causing gastric outlet obstruction in an adult. West Afr J Med. 18(1):73-4, 1999
                                14. Dwek JR et al: The duodenal dimple: a specific fluoroscopic correlate to the duodenal web. Pediatr Radiol. 29(6):467-8, 1999
                                15. Fujiwara T et al: Intraluminal duodenal diverticulum in a child: incidental onset possibly associated with the ingestion of a foreign body. Eur J Pediatr. 158(2):108-10, 1999
                                16. Huang FC et al: Congenital duodenal membrane: a ten-year review. Acta Paediatr Taiwan. 40(2):70-4, 1999
                                17. Price J: Adult duodenal web. Australas Radiol. 42(4):397-8, 1998
                                18. Alizai NK et al: Duodenal web presenting with acute pancreatitis. J Pediatr Surg. 32(8):1255-6, 1997
                                19. Buonomo C: Neonatal gastrointestinal emergencies. Radiol Clin North Am. 35(4):845-64, 1997
                                20. Kannan S et al: Nonsteroidal anti-inflammatory drug induced duodenal web. S D J Med. 50(11):393-4, 1997
                                21. Golombek S et al: Duodenal web with preduodenal portal vein. Iowa Med. 85(6):247-9, 1995
                                22. Nagpal R et al: Duodenal web presenting with gastrointestinal bleeding in a seven-month-old infant. J Pediatr Gastroenterol Nutr. 16(1):90-2, 1993
                                23. Soreide JA et al: Intraluminal duodenal diverticulum: case report and update of the literature 1975-1986. Am J Gastroenterol. 83(9):988-91, 1988
                                24. Sheridan RL et al: Adult duodenal web associated with reflux esophagitis. Am J Gastroenterol. 81(8):718-20, 1986
                                25. Ferraris VA et al: Adult duodenal web associated with peptic ulcer disease. Surg Gynecol Obstet. 158(5):461-3, 1984
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Top Differential Diagnoses

                                      • Pathology

                                        • Clinical Issues

                                          TERMINOLOGY

                                          • Definitions

                                            • Incomplete diaphragm of duodenal lumen causing high-grade duodenal obstruction
                                            • Duodenal atresia (DA) spectrum but with later clinical presentation

                                          IMAGING

                                          • General Features

                                            • Radiographic Findings

                                              • Fluoroscopic Findings

                                                • Ultrasonographic Findings

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Demographics

                                                            • Treatment

                                                              Selected References

                                                              1. Tsitsiou Y et al: Diagnostic decision-making tool for imaging term neonatal bowel obstruction. Clin Radiol. 76(3):163-71, 2021
                                                              2. Medscape: Intestinal Atresia, Stenosis, and Webs. Duodenal Stenosis and Atresia. Updated 19, 2021. Accessed July 4, 2021. http://emedicine.medscape.com/article/940615-overview, Intestinal Atresia, Stenosis, & Webs
                                                              3. Hameed S et al: The role of sonography in differentiating congenital intrinsic duodenal anomalies from midgut malrotation: emphasizing the new signs of duodenal and gastric wall thickening and hyperechogenicity. Pediatr Radiol. 50(5):673683, 2020
                                                              4. Wettasinghe MC et al: Gastroduodenal emphysema with portal venous air due to congenital duodenal web in a child: a case report and review of literature. Case Rep Pediatr. 2020:9897208, 2020
                                                              5. Tu LH et al: Duodenal intussusception secondary to web presenting as recurrent pancreatitis in a 7-year-old girl. Pediatr Radiol. 46(3):426-9, 2016
                                                              6. Wood LS et al: Endoscopic division of duodenal web causing near obstruction in 2-year-old with trisomy 21. J Laparoendosc Adv Surg Tech A. 26(5):413-7, 2016
                                                              7. Eksarko P et al: Duodenal web associated with malrotation and review of literature. J Surg Case Rep. 2013(12), 2013
                                                              8. Muensterer OJ et al: Resection of a duodenal web using single-incision pediatric endosurgery. J Pediatr Surg. 46(5):989-93, 2011
                                                              9. Melek M et al: Two cases of duodenal obstruction due to a congenital web. World J Gastroenterol. 14(8):1305-7, 2008
                                                              10. Mustafawi AR et al: Congenital duodenal obstruction in children: a decade's experience. Eur J Pediatr Surg. 18(2):93-7, 2008
                                                              11. Fisher JC et al: Gastric outlet obstruction as a consequence of a duodenal web masquerading as gastrinoma in an adult. Curr Surg. 60(6):602-6, 2003
                                                              12. Yoon CH et al: Sonographic windsock sign of a duodenal web. Pediatr Radiol. 31(12):856-7, 2001
                                                              13. Adebamowo CA et al: Duodenal web causing gastric outlet obstruction in an adult. West Afr J Med. 18(1):73-4, 1999
                                                              14. Dwek JR et al: The duodenal dimple: a specific fluoroscopic correlate to the duodenal web. Pediatr Radiol. 29(6):467-8, 1999
                                                              15. Fujiwara T et al: Intraluminal duodenal diverticulum in a child: incidental onset possibly associated with the ingestion of a foreign body. Eur J Pediatr. 158(2):108-10, 1999
                                                              16. Huang FC et al: Congenital duodenal membrane: a ten-year review. Acta Paediatr Taiwan. 40(2):70-4, 1999
                                                              17. Price J: Adult duodenal web. Australas Radiol. 42(4):397-8, 1998
                                                              18. Alizai NK et al: Duodenal web presenting with acute pancreatitis. J Pediatr Surg. 32(8):1255-6, 1997
                                                              19. Buonomo C: Neonatal gastrointestinal emergencies. Radiol Clin North Am. 35(4):845-64, 1997
                                                              20. Kannan S et al: Nonsteroidal anti-inflammatory drug induced duodenal web. S D J Med. 50(11):393-4, 1997
                                                              21. Golombek S et al: Duodenal web with preduodenal portal vein. Iowa Med. 85(6):247-9, 1995
                                                              22. Nagpal R et al: Duodenal web presenting with gastrointestinal bleeding in a seven-month-old infant. J Pediatr Gastroenterol Nutr. 16(1):90-2, 1993
                                                              23. Soreide JA et al: Intraluminal duodenal diverticulum: case report and update of the literature 1975-1986. Am J Gastroenterol. 83(9):988-91, 1988
                                                              24. Sheridan RL et al: Adult duodenal web associated with reflux esophagitis. Am J Gastroenterol. 81(8):718-20, 1986
                                                              25. Ferraris VA et al: Adult duodenal web associated with peptic ulcer disease. Surg Gynecol Obstet. 158(5):461-3, 1984