A rare case report of infant ileal atresia with double appendix

Small bowel atresia has quite an incidence in infants particularly in males. It is usually seen to be the most common cause of bowel obstruction in neonates since birth. It may be associated with other congenital anomalies.

A 4 day old neonate presented with abdominal distension, billous vomiting & non passage of stools since birth. On further examination, it was seen that the abdominal distension was mostly central & there was hyperperistaltic bowel sounds on auscultation. The infant also had scoliosis. There was decreased appetite & features of dehydration. Diagnosed by USG(W/A), infantogram & X-Ray plain picture abdomen.

The mortality from the atresia of ileum is greater owing to the incidence of early perforation. Infants may present with features discussed above. They usually present during the 1st week of life but majority of the babies presenting late have significant mortality. Early surgical intervention with excision of the dilated bowel segment with anastomosis of the proximal (normal caliber bowel) to the distal part of the bowel has been seen to have been associated with decreased morbidity & mortality.

It has been observed that one of the many causes for neonatal intestinal obstruction is attributed to small bowel atresia. This has been associated with successful outcome depending on the presentation of the child to the hospital to the timing of surgical intervention along with resuscitation & starting of enteral feeds. Small bowel atresia can be associated with antenatal morbidity in the mother as cited here.