Prognosis of Jejunoileal Atresia Treated by Resection and Anastomosis in the Resource-limited Environment
Salihou Aminou Sadjo1, Fossi Kamga Gacelle2, Abouamé Palma Haoua3
1Department of Pediatric, Maroua Regional Hospital, Maroua, Cameroon.
Insights
Surgical treatment of jejunoileal atresia using resection and anastomosis is feasible in resource-limited settings. This approach can achieve acceptable outcomes for neonatal intestinal obstruction, though improvements in parenteral nutrition are needed.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Gastrointestinal Surgery
Background:
- Jejunoileal atresia is a leading cause of intestinal mechanical obstruction in newborns.
- Resection and anastomosis, with or without gastrointestinal tapering, is a critical surgical intervention.
- This study evaluates this surgical approach in resource-limited environments.
Background:
Jejunoileal atresia is the most common etiology of intestinal mechanical obstruction. Several surgical techniques have been described in the therapeutic approach to this condition. Treatment by resection and anastomosis with or without gastrointestinal tapering remains a life-saving option in our daily practice. The aim of our study was to report the results of the surgical treatment of jejunoileal atresia by resection and anastomosis in the resource-limited environment.
Materials And Methods:
We carried out a prospective, descriptive study from November 1st 2021, to October 31st, 2023, equating to 2 years, in the Pediatric Surgery Department. All the records of newborns aged from day 0 to day 21 with jejunoileal atresia, only treated by resection and anastomosis were included. The parameters studied were age at presentation, sex, gestational age, type of atresia, associated malformations, morbidity, mortality, and follow-up.
Results:
A total of 10 newborns were treated. The median age at the presentation was 2.2 days (1 to 4 days). The male sex was predominant with a sex ratio of 7:3. Prematurity was reported in two cases. No antenatal diagnosis was reported. The type I atresia according to the Martin classification was most commonly found (5 cases). Inguinoscrotal hernia and Ladd bands were associated in 1 case each. Resection and anastomosis with intestinal tapering was performed in all newborns. Surgical site infection was noted in 1 case. We recorded three deaths due to sepsis in our series.
Conclusions:
In spite of the limitations inherent to low- and middle-income countries region, our current series shows that it is feasible to achieve the acceptable surgical outcomes in neonatal intestinal obstruction due to intestinal atresia. Rigorous adherence to protocols and improvements in the availability of parenteral nutrition are likely to contribute to optimal outcomes in future.
