P597 Neonatal seizures revealing duodenal atresia

Introduction Atresia of the intestine is one of the most common reasons for intestinal obstruction of the newborn. As the ileum is the most frequently affected part, duodenum atresia is less frequent with an incidence ranging from 1 in 20,000 to 1 in 40,000 births. We report the case of a newborn with duodenal atresia. Observation This is a 5-day old female newborn admitted for abnormal movement. She comes from a complicated pregnancy of hydramnios. The history backs to the birth marked by the installation of iterative vomiting. Two days before admission, these vomits became bilious with refusal of feeding and occurrence of abnormal movements such as ocular revulsion and hypertonia. At admission, the patient was icteric and severely dehydrated. The abdomen was depressible without mass. She had a good axial and peripheral tonus with the presence of archaic reflexes. Two hours after admission, she had a convulsive seizure with head deviation eyes that recurred 2 times. In biology, there was a hypochloremic metabolic alkalosis, acute renal failure with urea at 33.5 mmol/l and serum creatinemia at 517.83 μmol/l, the infectious balance was negative. The lumbar puncture was normal. Radio showed significant gastric distention with poor aeration of the rest of the digestive tract. Abdominopelvic ultrasonography found hyperechoic kidneys related to functional renal failure, gastric distention, and umbilical vein thrombosis. It was then supplemented by a digestive opacification which objectified a duodenal atresia in its complete form. Our patient is operated after stabilization. He benefited from a side-lateral duodeno-duodenostomy. The postoperative course was simple. The reintroduction of the diet was progressive with good digestive tolerance. The patient was seen at the consultation with a follow-up of 3 months, she has a good weight gain and a normal transit. Conclusion Duodenal atresia is a relatively rare cause of bowel obstruction. Antenatal diagnosis when done allows better management from birth. This pathology remains a good prognosis when it is isolated.