Congenital ileal stenosis

Congenital jejunal-ileal atresia (JIA) is a critical neonatal diagnosis, as morbidity and mortality can be high if not treated. JIA usually presents with obstipation, and diagnosis can be established with history and physical exam, radiography, and contrast fluoroscopy. This case demonstrates ileal stenosis, a rare type of JIA, presents with intermediate obstructive symptoms. A 39-week newborn female presented with bilious emesis and dilated loops of bowel on X-ray. Contrast fluoroscopy ruled out volvulus and colonic pathology. Patient had persistent bowel function and had evolving but persistent small bowel dilation with eventual pneumatosis on Day 10. Exploratory laparotomy revealed ileal stenosis with proximal dilated bowel. She underwent resection and primary anastomosis. She recovered well and is progressing appropriately. Congenital ileal stenosis is a rare type of atresia with incomplete obstruction of the lumen resulting in equivocal obstructive symptoms. This presents a diagnostic dilemma as classical congenital atresias present with obstipation.