CASE REPORT Duodenal stenosis, a new finding on congenital rubella syndrome: Case description and literature review Antonella Diamanti a, *, Andrea Pietrobattista a , Enza Bevivino b , Paola De Angelis c , Angelica Calce a , Luigi Dall’Oglio c , Manuela Gambarara a a Children’s Hospital, Gastroenterology and Nutrition Unit, Piazza S. Onofrio 4, Rome, Italy b Children’s Hospital, Metabolic Disease Unit, Piazza S. Onofrio 4, Rome, Italy c Children’s Hospital, Digestive Surgery Unit, Piazza S. Onofrio 4, Rome, Italy Accepted 23 January 2006 Available online 20 March 2006 KEYWORDS Congenital rubella syndrome; Duodenal stenosis; Gastrointestinal disease Summary Congenital rubella syndrome (CRS) continues to represent a public healthcare problem although an effective vaccination program. Gastrointestinal in- volvement is rather infrequent and the association of CRS with duodenal stenosis has been never reported. In this study a case of CRS with duodenal diaphragm is reported and the gastrointestinal diseases described in association with CRS are reviewed. A 10-month-old child affected by CRS with congenital hearth disease, perceptive deafness and microcephaly, was admitted because of vomiting and fail- ure to thrive. An upper endoscopy demonstrated dilated proximal duodenum and a perforated diaphragm in the second segment of the duodenum. Endoscopic mem- branectomy was therefore performed. Two months later the patient was submitted to a further endoscopic evaluation that showed a partial diaphragm persistence and a second excision was performed. Follow-up one year after the first treatment showed good clinical conditions, reasonable physical growth and disappearance of vomiting. In conclusion we report the first case of CRS in association with duode- nal stenosis. Duodenal stenosis in the absence of other intestinal localizations may be due to rubella capacity of infecting only small numbers of fetal cells but we can- not exclude that the duodenal stenosis in our patient be only a casual association. ª 2006 The British Infection Society. Published by Elsevier Ltd. All rights reserved. * Corresponding author. Tel.: þ39 0668592329; fax: þ39 0668592876. E-mail address: diamanti@opbg.net (A. Diamanti). 0163-4453/$30 ª 2006 The British Infection Society. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jinf.2006.01.020 Journal of Infection (2006) 53, e207ee210 www.elsevierhealth.com/journals/jinf