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Duodenum is a common site for congenital anomalies that might result in partial or complete obstruction. Intestinal rotational anomalies that involve the midgut put the duodenum at a potential risk of obstruction. This is a retrospective hospital record based study displaying an 8 year single center experience in the Basrah center of pediatric surgery. The study enrolled 60 children with congenital duodenal obstruction with a mean age of 2.8 months and a male to female ratio of 1.14:1. Thirty two patients (53.3%) were diagnosed as duodenal atresia and stenosis, while intestinal malrotation was reported in 28 patients (46.7%). Repeated vomiting was the most common presenting symptom, it was bile stained in 60%. Associated congenital anomalies were seen in 23.3% of the study population, Down's syndrome and congenital heart defects were the most commonly reported abnormalities. Intraoperatively, fenestrated duodenal web was the commonest finding (59.4%) in duodenal atresia/stenosis, which was corrected by a diamond anastomosis in 1.9% of cases and by duodenotomy with web excision in 28.1%. Malrotation was corrected by Ladd's operation in 92.9%. Postoperative complications were reported in one third of the studied population, and the type of surgical procedure used in duodenal atresia/stenosis did not have a significant impact neither on postoperative complications nor on the hospital stay. Introduction uodenum is an interesting part of upper gastrointestinal tract for the majority of pediatric surgeons, due to its unique embryological, anatomical, physiological and pathological characteristics. Congenital duodenal obstruction (CDO) can be the result of intrinsic duodenal pathology or due to extrinsic compression which is ultimately causing either complete or partial obstruction. Duodenal atresia is the most common cause of CDO and occurs in 1 per 5000 to 1 per 10000 live births; this intrinsic duodenal lesion is believed to be caused by recanalization failure of the developing duodenum, resulting in complete obstruction of duodenal lumen. The extrinsic form of CDO is caused by defects in the development of adjacent structures like malrotation of midgut, Ladd's bands, annular pancreas and preduodenal portal vein. Intestinal malrotation is a spectrum of malformation in which the bowel is not fixed adequately in a proper way and the base of mesentery is narrow that puts the midgut at a potential risk of volvulus (partial or complete duodenal obstruction) and finally may cause midgut ischemia and gangrene because of compression on superior mesenteric artery. Intraoperative finding of annular pancreas should point to the presence of CDO (partial or complete) in which pancreatic tissues forming a complete ring around the duodenum rather than being located in the medial aspect of the C-shaped duodenum. This study aimed to review children with CDO who were reported in Basrah pediatric surgery center in order to identify the underlying pathology and also D

DUODENAL OBSTRUCTION IN CHILDREN: AN EIGHT YEAR EXPERIENCE IN BASRAH