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Background: Fenestrated duodenal membrane is a form of congenital duodenal webs in whom the diagnosis is missed or delayed often.
Case presentation: We will present the case of a two-year- old girl diagnosed at birth with Down syndrome and 12 month old she was diagnosed with celiac disease. After gluten free diet this girl presented a good weight gain but her mother referred that last months she was vomiting frequently. Her mother denied to have seen bilious vomiting but she noticed in vomiting some kind of foods swallowing one or two weeks ago. Radiological images were confident with duodenal obstruction. After surgical laparotomy we noticed a fenestrated duodenal membrane.
Discussion: Fenestrated duodenal membrane is a rare congenital disorder. Sometimes the diagnostic may be delayed when the symptoms are not characteristic or dedicated to a different pathology. In our case nonbilious vomiting and celiac disease made us to underestimate initially this congenital anomaly.
Conclusion: Every child with Down syndrome should be evaluated for rare digestive disorder despite of no characteristic signs or the presence of another digestive pathology. Surgery remains the gold standard of therapy.