Endoscopic treatment of congenital perforated duodenal web: a literature review and evaluation of own results

This article presents comparative results of treating congenital high partial intestinal obstruction caused by a perforated duodenal web in newborn and infants under 1 year of age, treated at the Republican Scientific and Practical Center of Pediatric Surgery between 2017 and 2025. Endoscopic membranotomy and a novel endoscopic technique (balloon dilation over a pre-placed guidewire via endoscopic access) were used instead of the classical surgical technique with laparotomy. A literature review on methods for restoring duodenal patency in children in global practice was conducted. Intraoperative and long-term outcomes of duodenal lumen restoration in children using the novel endoscopic technique were evaluated. The novel endoscopic technique was compared with the classical surgical approach. The economic efficiency of the novel endoscopic technique for restoring duodenal lumen patency in children was calculated.

1. Meinzer A., Alkatout I., Krebs T.F., et al. Advances and trends in pediatric minimally invasive surgery. J Clin Med. 2020; 9(12). doi: 10.3390/jcm9123999.

2. Tripathi P.R., Sen Sarma M., Yachha S.K., et al. Gastrointestinal polyps and polyposis in children: experience of endoscopic and surgical outcomes. Dig Dis. 2021; 39(1): 25–32. doi: 10.1159/000508866.

3. Hsu Chien-Ting, Chen Chien-Chuan, Lee Ching-Tai, et al. Effect of peroral endoscopic myotomy on growth and esophageal motility for pediatric esophageal achalasia. J Formos Med Assoc. 2024; 123(1): 62–70. doi: 10.1016/j.jfma.2023.08.007.

4. Okamatsu T., Arai K., Yatsuzuka M., et al. Endoscopic membranectomy for congenital duodenal stenosis in an infant. J Pediatr Surg. 1989; 24(4): 367–368. doi: 10.1016/s0022-3468(89)80271-4.

5. Van Rijn R.R., Van Lienden K.P., Fortuna T.L., et al. Membranous duodenal stenosis: initial experience with balloon dilatation in four children. Eur J Radiol. 2006; 59(1): 29–32. doi: 10.1016/j.ejrad.2006.03.015.

6. Blanco-Rodriguez G., Penchyna-Grub J., Porras-Hernandez J.D., Trujillo-Ponce A. Transluminal endoscopic electrosurgical incision of fenestrated duodenal membranes. Pediatr Surg Int. 2008; 24(6): 711–714. doi: 10.1007/s00383-008-2142-8.

7. Goring J., Isoldi S., Sharma S., et al. Natural orifice endoluminal technique (NOEL) for the management of congenital duodenal membranes. J Pediatr Surg. 2020; 55(2): 282–285. doi: 10.1016/j.jpedsurg.2019.10.025.

8. Torroni F., De Angelis P., Caldaro T., et al. Endoscopic membranectomy of duodenal diaphragm: pediatric experience. Gastrointest Endosc. 2006; 63(3): 530–531. doi: 10.1016/j.gie.2005.10.001.

9. Sun Song, Zheng Shan, Wu Jie, et al. Clinical application of endoscopic diaphragmotomy and dilation in a congenital duodenal diaphragm. Front Pediatr. 2024; 12. doi: 10.3389/fped.2024.1298748.

10. Wang Xing, Lin Kai, Liu Haifeng, et al. Endoscopic balloon dilatation-based membrane resection for membranous duodenal stenosis: a feasibility and safety study (with video). J Pediatr Gastroenterol Nutr. 2023; 77(2). doi: 10.1097/MPG.0000000000003848.

11. Troyan V.V., Pataleta O.A. Ability to excise congenital perforated membrane of the duodenum. Patent BY. № а 20090547. 2011. 2. (in Russian)

12. Thomson M., Sharma S., Torroni F., Goring J. Duodenal web division by endoscopy. Practical Pediatric Gastrointestinal Endoscopy. Wiley-Blackwell; 2021. 347–349.

13. Marakhouski K., Malyshka E., Nikalayeva K., et al. Balloon dilation of congenital perforated duodenal web in newborns: evaluation of short and long-term results. World J Gastrointest Endosc. 2024; 16(6): 343–349.

14. Marakhouski, K. Endoscopic treatment of congenital perforated duodenal web (CPDW). JPGN Reports. 2024; 5(S3): S276. doi: 10.1002/jpr3.12148.

15. Marakhouski K.Yu. Advancing the diagnostic accuracy of high congenital intestinal obstruction syndrome in pediatric patients using esophagogastroduodenoscopy. Scientific research of the SCO countries: synergy and integration. Beijing, 2025. 58–68. doi 10.34660/INF.2025.22.43.045.

16. Huang Mao-Hua, Bian Hong-qiang, Liang Chong, et al. Gastroscopic treatment of membranous duodenal stenosis in infants and children. J Pediatr Surg. 2015. 50(3): 413–416.

17. Poddar U., Jain V., Yachha S.K., Srivastava A. Congenital duodenal web: successful management with endoscopic dilatation. Endosc Int Open. 2016; 4(3). doi: 10.1055/s-0041-110955.