A pregnant woman diligently monitored her pregnancy, and during a fetal ultrasound, a possible blockage in the intestines and duodenum was suspected. Following delivery, the pediatric surgery team at the International Medical Center (IMC) examined the case and diagnosed the child with Down syndrome. Through specialized and precise imaging studies, the team confirmed the presence of an obstruction caused most probably by an annular pancreas encasing the duodenum and resulting in a rare and complex condition known as duodenal atreasia and stenosis.

The procedure followed in this complex case required the removal of the obstruction while ensuring the preservation of three vital and delicate organs: the pancreas, the bile duct, and the duodenum. The doctors carefully devised a treatment plan suitable for the three-day-old infant and explained it to the parents.

The medical team faced several challenges. The initial challenge was accurately diagnosing the condition during pregnancy. Consequently, immediate post-birth imaging studies  with contrast were performed to obtain a precise diagnosis.

The second challenge was the choice of treatment method. A traditional open laparotomy surgery on the newborn, who was only three days old and weighed 2.7 kg, was the easiest choice for the pediatric surgery team. However, the team opted for a modern and minimally invasive approach by using a specialized laparoscopy device designed for infants. This decision aimed to minimize the surgical impact on the infant, such as infections, pain, and wound complications. Furthermore, this approach eliminated the need for abdominal incisions and expedited recovery for the newborn.

The laparoscopy procedure involved making three small openings through which the laparoscopic instruments and camera could access the abdomen. Using suturing technology under the surgical laparoscope (intracorporal), the medical team successfully created a connection between the intestines to bypass the obstruction without compromising the function of the pancreas. This technique enabled the newborn baby to recover in just one week.

The team of surgeons who performed the procedure included Dr. Mohammed Ageel, Pediatric Surgery Consultant, Dr. Nawaf Aldajani, Pediatric/NICU Consultant, Dr. Ahmad May, Pediatric Surgery Specialist, and Dr. Yasir Aldahshan, Anesthesia Consultant, in addition to the nursing team.