Delayed Presentation of Perforated Duodenal Diaphragm in Infants and Children: Our Institutional Experience in a Tertiary Care Hospital

Background: This was our institutional experience about infant and children of perforated duodenal diaphragm presenting with recurrent vomiting, delayed due to late visit to the paediatric surgeon. Aim and Objective: The aim of this study was to observe the clinical presentation, diagnostic challenges, reasons for delay in the diagnosis and management of infant and children with perforated duodenal diaphragm. Material and Methods: This is a clinical observational study conducted from September 2018 to December 2020. There were eight patients (2 male and 6 female) in our study. Results: Out of eight patients, five patients presented with on and off non-bilious vomiting, six (75%) had < 3rd percentile of weight for age at the time of admission. Associated anomalies were malrotation (50%), ventricular septal defect (25%), and Downs's syndrome in one patient (12.5%). Conclusion: Delayed presentation of perforated duodenal diaphragm is a rare surgical condition. Early diagnosis is a challenge for the treating physician. Detailed history of recurrent vomiting, proper clinical examination, relevant investigation and referral to the paediatric surgeon with high index of suspicion can aid in early diagnosis.