Although its incidence is estimated at 1 in 20,000 to 40,000 newborn, duodenal atresia is the third most frequent type of atresia of the digestive system, affecting almost equally men and women. This congenital malformation, classified as rare, could be defined as a "canal closure". The canal would be the first part of the small intestine (duodenum), whose total obstruction (atresia) prevents the contents lodged in the stomach (food, liquids, gases) from passing into the rest of the intestine. Such obstruction may also be partial and, in this case, is called stenosis, described as a thinning of the lumen of the duodenum.
There are several types of duodenal atresia, with Type 1 being one of the most complexes because the two intestinal ends are separated. "When we talk about newborn patients the complexity increases, first of all, because of their anatomical characteristics and in the second place because of the use of anaesthesia. However, we have to recognise that thanks to the use of ultrasound and other radiological studies, the vast majority of diagnoses of duodenal atresia are prenatal" says Dr Juan Perez Rodriguez, who works as a pediatric surgeon both in the Vithas Parque San Antonio Hospital and Vithas Xanit International Hospital.
This intervention was performed on a baby girl only 24 hours old, who was diagnosed prenatally with duodenal atresia with a double-bubble sign. After the ante-natal monitoring and subsequent delivery, an abdominal x-ray was performed confirming both diagnoses and have led to a laparotomy identifying Type 1 atresia. Posteriorly intestinal anastomosis was performed allowing the passage of contents from the area anterior to the obstruction or atresia, to the rest of the intestine. In the first 24 hours post-op feeding of the newborn infant commenced, and after 5 days the transit permeability was checked. The positive results of this assessment allowed the removal of the nasogastric feeding tubes to begin feeding with breast milk immediately. The patient was discharged on the sixth postoperative day and, after several weeks of monitoring, the progress was very favourable tolerating feeding, without vomiting and with a healthy and progressive weight gain.
Duodenal atresia in lactating patients is classified as a complex intervention due to, among other issues, the physiological particularities of the infants.
Once the baby is stabilised, the final treatment is the duodenum surgery to remove or bypass the blocked part of the duodenum. Much of the complexity of this intervention lies in rejoining the duodenum passing the obstruction zone. This junction of the two intestinal ends restores the continuity of the intestine, with subsequent passing of the feeding tube via the anastomosis (junction) through which the baby can be fed immediately. As mentioned above in the case addressed by Dr Perez, after surgery, feeding is performed through the tube until the same is removed and the baby is ready to be fed by mouth.
The Vithas Promise: high quality accredited healthcare, personal service and long term investment
Vithas is the first healthcare operator with 100 por ciento Spanish capital. Its strategic commitment is defined by supporting the healthcare with the standards of quality accreditation of the highest international prestige, the Joint Commission International. Only 14 prestigious hospitals in Spain have such accreditation and recognition, and two of them are part of Vithas, in Madrid and Malaga. Each year Vithas cares for more than 5.000.000 patients in its 19 hospitals and 28 medical centres called Vithas Salud. The 47 centres are distributed throughout the country and include hospitals in Alicante, Almeria, Benalmadena, Castellon, Granada, Las Palmas de Gran Canaria, Lleida, Madrid, Malaga, Sevilla, Tenerife, Vigo, Valencia and Vitoria-Gasteiz. The 28 Vithas Salud centres are located in Alicante, Almuñecar, Elche, El Ejido, Fuengirola, Granada, La Estrada, Las Palmas de Gran Canaria, Lleida, Madrid, Malaga, Marin, Nerja, Pontevedra, Rincon de la Victoria, Sanxenxo, Sevilla, Torre del Mar, Torremolinos, Vilagarcia, and Vitoria-Gasteiz. Vithas also counts upon more than 300 extraction points spread throughout Spain thanks to its network of Vithas Lab laboratories. Its own central purchasing office, PlazaSalud24, as a leader in the sector, provides service to 39 hospitals, 35 medical centres and 20 dental clinics.
Vithas has a strategic agreement with a hospital leader in the Balearic Islands, the Juaneda Healthcare Network, which has 5 hospitals and a wide network of medical centres throughout the region.
Vithas' commitment to accredited quality healthcare and personalised service goes hand in hand with the firm support and long-term vision of Vithas' shareholders: Goodgrower, who control 80 por ciento of the capital, and the' La Caixa' group, with the remaining 20 por ciento. With a growth model based on geographical diversification and sustainability, Vithas plans to continue consolidating its national presence both by opening new centres and through acquisitions and strategic agreements.