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Incidence of late severe intestinal complications after bowel atresia/stenosis
Takahiro Hosokawa1, Yutaka Tanami1, Yumiko Sato1
1Department of Radiology, Saitama Children's Medical Center, Saitama, Japan.
Insights
Congenital intestinal atresia/stenosis repair can lead to severe complications like adhesive ileus. Complications were more frequent with anal-side atresia/stenosis and high-risk types, necessitating careful patient monitoring.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Research
Background:
- Congenital intestinal atresia/stenosis requires surgical repair in infants.
- Late severe intestinal complications can arise post-surgery, impacting patient outcomes.
- Identifying risk factors is crucial for improving long-term management.
Purpose of the Study:
- To determine the incidence of late severe intestinal complications after surgical repair for congenital intestinal atresia/stenosis.
- To identify risk factors associated with these complications, including location and type of atresia/stenosis.
Main Methods:
- A cohort of 51 patients undergoing surgical repair for intestinal atresia/stenosis was analyzed.
- Complications were defined as adhesive ileus, incisional hernia, or volvulus.
- Statistical analysis (Fisher's exact test) compared complication rates based on atresia/stenosis location (oral vs. anal to Treitz ligament) and risk type (low vs. high).
Main Results:
- Late intestinal complications occurred in 15.7% of patients (8 out of 51).
- All complications were observed in patients with atresia/stenosis located on the anal side of the Treitz ligament.
- A significant association was found between complication incidence and both the location (P=0.005) and risk type (P=0.023) of intestinal atresia/stenosis.
Conclusions:
- Location and type of congenital intestinal atresia/stenosis are significant risk factors for late severe intestinal complications.
- Physicians should be vigilant for these complications in patients with jejunal and ileal atresia/stenosis presenting with abdominal symptoms.
- Consideration of these factors can guide surgical planning and postoperative care.
Background:
To determine the incidence and risk factors for late severe intestinal complications after surgical repair for intra-abdominal congenital intestinal atresia/stenosis.
Methods:
We included 51 patients who underwent surgical repair for congenital intestinal atresia/stenosis. Late severe intestinal complications included adhesive ileus, incisional hernia, or volvulus. Whether surgical intervention was urgent or not was recorded. The location of the atresia/stenosis was classified into two groups: atresia/stenosis located at the oral or anal side from the Treitz ligament. The type of atresia/stenosis was classified as low-risk types (type I, mucosal web/II, fibrous cord/IIIa, mesenteric gap defect) and high-risk types (IIIb, apple peel/IV, multiple atresia). We compared the incidence of late intestinal complications between the location of intestinal atresia/stenosis at the oral and anal side of Treitz ligament, and between low- and high-risk types of atresia/stenosis using Fisher's exact test.
Results:
Eight (15.7%) had late intestinal complications, all of which occurred in patients with intestinal atresia/stenosis located on the anal side of the ligament of Treitz. Urgent surgical intervention was needed in four cases. There was a significant difference in the location of atresia/stenosis (with vs. without late intestinal complications at oral/anal side of the Treitz ligament: 0/8 vs. 24/19; P = 0.005) and the type of intestinal atresia/stenosis (with vs. without that accompanying low-/high-risk type: 5/3 vs. 41/2; P = 0.023).
Conclusions:
Physicians should consider the presence of intestinal complications that require surgical intervention in patients undergoing surgical reconstruction for jejunal and ileal atresia/stenosis with abdominal symptoms.
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