How is preoperative management of duodenal atresia primarily approached?

The preoperative management of duodenal atresia is primarily approached through gastric decompression and hydration. This strategy is critical because neonates with duodenal atresia typically present with bilious vomiting and abdominal distension due to the obstruction caused by the atresia. Gastric decompression is achieved using a nasogastric tube, which helps relieve pressure in the stomach and prevents further complications such as aspiration or perforation.

Hydration is equally important, as these infants may have significant fluid and electrolyte imbalances due to ongoing emesis and inability to feed. By providing IV fluids, healthcare providers can correct these imbalances and stabilize the infant for the upcoming surgical procedure. This approach ensures that the infant is in the best possible condition, minimizing the risk of perioperative complications.

Immediate surgical intervention is not the primary approach because stabilization through gastric decompression and hydration must occur first. While antibiotic therapy may be considered if there is concern for infection, it is not the cornerstone of preoperative management for duodenal atresia. Parenteral nutrition is not appropriate in this scenario as the obstruction prevents any enteral feeding; the priority is decompression and hydration rather than initiating parenteral nutrition. Thus, the correct management focuses on addressing