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Long-term outcome after repair of congenital duodenal obstruction is excellent with contemporary operative survival exceeding 95% and with the majority of patients reported as asymptomatic and with normal growth.

The main factors contributing to the mortality in patients with duodenal obstruction are a high incidence of associated anomalies, prematurity and low birth weight. The associated complex cardiac defects continue to be the leading cause of death in particular in infants with trisomy 21. However, recent reviews document that advances in both paediatric cardiology, and cardiac surgery in neonates and infants have reduced this mortality significantly.

Early post-operative complications include anastomotic obstruction, continuing obstruction due to missed anomalies, leakage at the anastomosis and prolonged adynamic ileus. Upper intestinal radiographic studies are necessary to reveal the source of the problem.

The late gastrointestinal complications include megaduodenum, duodenogastric reflux, gastritis, peptic ulcer and gastro-oesophageal reflux. Megaduodenum is a particularly troublesome problem, which may result either from anastomotic obstruction or from an inherent motility disorder of the proximal duodenum.

The vast majority of patients treated with any one of the standard pull-through procedures achieve satisfactory continence and function with time. The attainment of normal continence is dependent on the intensity of bowel training, social background and respective intelligence of patients. Mental handicap, including Down syndrome, is invariably associated with long-term incontinence.

Duplication of the renal pelvis and ureters is the commonest anomaly of the upper urinary tract. It occurs in approximately 0.8% of the population and in 1.8–4.2% of pyelograms. Commonly these are asymptomatic. However, they can challenge the diagnostic acumen with a wide variety of manifestations.

Post-operative care includes nasogastric tube drainage of the stomach and intravenous fluids are required until normal gastrointestinal function is reestablished. Post-operative antibiotics may be given for prophylaxis against wound infection if indicated.

Failure of the viteline duct to regress results in anomalies that may require resection to prevent or treat complications. The risk of post-operative complications, notably wound infection, is low and the outcome of surgery is excellent. Successful use of a laparoscopic approach for these anomalies has been reported.

The vast majority of patients treated with any one of the standard pull-through procedures achieve satisfactory continence and function with time. The attainment of normal continence is dependent on the intensity of bowel training, social background and respective intelligence of patients. Mental handicap, including Down syndrome, is invariably associated with long-term incontinence.

Advances in peri-operative care and antibiotics have resulted in a zero mortality rate and low morbidity in children with appendicitis. The long-term outcome of the vast majority of patients who undergo appendectomy in childhood is very good. A small number of patients may develop late adhesive intestinal obstruction.

Post-operative care includes nasogastric tube drainage of the stomach and intravenous fluids are required until normal gastrointestinal function is reestablished. Post-operative antibiotics may be given for prophylaxis against wound infection if indicated.

Failure of the viteline duct to regress results in anomalies that may require resection to prevent or treat complications. The risk of post-operative complications, notably wound infection, is low and the outcome of surgery is excellent. Successful use of a laparoscopic approach for these anomalies has been reported.