A CASE OF MALROTATION ASSOCIATING WITH DUODENAL ATRESIA AND MENBRANOUS STENOSIS

We experienced a case of malrotation associating with duodenal atresia and menbranous stenosis. The patient is a male newborn who was born after 33 gestational weeks and weighted 2, 064g at birth. He was operated on at 2 days of age because the abdominal X-ray showed double bubble sign. The operation showed the malrotation and apple peel duodenal atresia. Then Ladd's procedure and end-to-end duodeno-enterostomy were performed after the apple peel portion of the intestine was resected. He developed vomiting after his weaning diet was started. Upper G. I. series showed the severely dilated duodenum at 1 year and 7 months of age. Adhesiotomy of the second operation resulted in no improve-ment of vomiting. Endoscopy finally revealed the menbranous stenosis of the duodenum at 1 year and 10 months of age. The third operation of excision of the menbrane gave good result. The malrotation sometimes associates with some intestinal malformations. Menbranous stenosis of the duodenum is easily overlooked. We think that passing of a balloon catheter into the intestine is useful to find such men-branous stenosis.