Duodenal Bowel Obstruction in a Teenage Female Patient

Abstract

The patient was an 11-year-old female patient with no relevant history. The condition began five days before her admission when she presented abdominal pain predominantly in the epigastrium accompanied by vomiting of food content up to eight times, without other accompanying or extenuating circumstances. The mother reported that the patient presented a decreased food intake of two years of evolution, referring that she was eating smaller portions than before.

On admission, the patient was found to have a pain facies, with significant abdominal distension and a body mass index of 16.8 kg/m2 (underweight). A nasogastric tube was placed and showed drainage of abundant biliary contents. Within his admission laboratory studies, leukocytosis (15.3 x103/μL), the discrete elevation of azo (urea: 56.8 mg/dL, BUN: 26.51 mg/dL), hypochloremia (93.7 mmol/L) and hyperamylasemia (102 U/L) were highlighted. A direct abdominal X-ray was performed (Figure 1), followed by a contrast-enhanced computed tomography (Figure 2).