The principles of treatment are to restore intestinal continuity whilst avoiding interference with the ductal system draining the pancreas and biliary tree. This is best achieved using a duodenoduo-

Figure 2.4 Variants of duodenal atresia. (a) Type 1 atresia due to an internal diaphragm; (b) type 2 atresia with blind-ending loops remaining connected by a fibrous cord; (c) type 3 atresia with blind ends completely separated; (d) type 4 - duodenal obstruction due to an annular pancreas.

denostomy in which the obstructed segment is bypassed by the proximal segment being joined directly to the distal segment. Following surgery the long-term gastrointestinal results are good.10

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