There is a wide variety of conditions which affect the small bowel in children, from the newborn period to adolescence. Many of these, including abdominal wall defects, meconium ileus, Crohn's disease, and the general topic of short bowel syndrome, are discussed elsewhere in this text. This chapter will review the long-term outcomes associated with congenital duodenal obstruction (i.e., atresia and webs), jejunoileal atresia and webs, Meckel's diverticulum, intussusception, malrotation, and intestinal duplication. Most children recover from these problems and go on to live a normal healthy life. For this reason, relatively few studies exist documenting long-term outcomes. In this chapter the authors have used a combination of the existing literature, and their own institutional experience, to document outcome in an objective way.

Long-term problems associated with small bowel disorders can be classified into several categories:

• those specific to the disorder itself (e.g., motility disturbances associated with atresia or malrotation);

• those that are a result of surgical intervention (e.g., short bowel syndrome following massive resection, or peritoneal adhesions following laparotomy);

• those related to underlying disease processes or associated anomalies.

Complications and survival can also be divided into early and late time periods. Since both may influence long-term outcomes, some disease processes require a discussion of both early and late morbidity and mortality.

Congenital duodenal obstruction

Although infants with complete duodenal atresia present in the neonatal period, duodenal web or stenosis may present later during the first years of life. The obstruction is postampullary in approximately 80% of patients and preampullary in 20%.