Closed loop foregut obstruction in a premature neonate

Multiple foregut atresias are exceedingly rare. We present a unique case of combined pyloric and duodenal atresia in a premature neonate. The anomaly appeared to evolve into a closed loop foregut obstruction in the postnatal period. Foregut continuity was established with a gastroduodenostomy, duodenoduodenostomy, and duodenal tapering. The child survived and continued to thrive at 2 years of age.