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Morbidity and mortality in small bowel atresia. Jejuno-ileal atresia
Insights
Small bowel atresia in infants has a high mortality rate, particularly jejunal atresia. Improved survival was linked to parenteral nutrition and a decline in the Bishop-Koop procedure
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Gastrointestinal Surgery
Background:
- Small bowel atresia is a congenital condition requiring surgical intervention.
- Historically, treatment outcomes for this condition have varied significantly.
- The Bishop-Koop procedure has been a common surgical approach.
Purpose of the Study:
- To evaluate the outcomes of small bowel atresia treatment over a 15-year period.
- To identify factors influencing mortality and morbidity in affected infants.
- To assess the efficacy of the Bishop-Koop procedure for small bowel atresia.
Main Methods:
- Retrospective review of 101 infants diagnosed with small bowel atresia between 1967 and 1981.
- Analysis of mortality rates, stratified by year and type of atresia (jejunal vs. ileal).
- Correlation of survival rates with the use of parenteral nutrition and specific surgical techniques.
Main Results:
- Overall mortality for small bowel atresia was 23%, with a reduction to 12% in 1974-1981.
- Jejunal atresia exhibited higher mortality compared to ileal atresia.
- Increased use of parenteral nutrition correlated with improved survival.
- The Bishop-Koop procedure was associated with high morbidity and mortality.
Conclusions:
- Parenteral nutrition significantly improved survival rates for infants with small bowel atresia.
- The Bishop-Koop procedure is not recommended for treating small bowel atresia due to poor outcomes.
- Continued research into optimal surgical and nutritional management is warranted.
Abstract:
One hundred and one babies were admitted to the Hospital for Sick Children, Great Ormond Street, London, between 1967 and 1981, suffering from small bowel atresia. The overall mortality in this period was 23%, although in the years 1974-81 this fell to 12%. Mortality was considerably higher in jejunal atresia than in ileal atresia. The improved survival in the second half of the series was related to more frequent use of parenteral nutrition. Morbidity and mortality following the Bishop-Koop procedure was high and this operation is inappropriate for the treatment of small bowel atresia.