Atresia of the small bowel
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This study analyzed 36 cases of intestinal atresia, finding that jejuno-ileal atresia, often caused by vascular accidents, requires ample resection. Anastomotic stricture was a common complication in both duodenal and jejuno-ileal atresia cases.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Neonatal Care
Background:
- Intestinal atresia is a congenital condition requiring surgical intervention.
- Duodenal atresia and jejuno-ileal atresia are distinct entities with varying presentations and etiologies.
- Understanding associated anomalies and postoperative complications is crucial for patient outcomes.
Purpose of the Study:
- To review surgical outcomes for duodenal atresia and jejuno-ileal atresia.
- To identify common symptoms, associated anomalies, and complications.
- To provide recommendations for surgical management, particularly for jejuno-ileal atresia.
Main Methods:
- Retrospective review of 36 patients diagnosed with intestinal atresia between 1969 and 1981.
- Analysis of patient demographics, clinical presentation, surgical procedures, and postoperative outcomes.
- Categorization of atresia into duodenal and jejuno-ileal types.
Main Results:
- 21 cases of duodenal atresia and 15 of jejuno-ileal atresia were identified.
- Associated anomalies were present in 14/21 (duodenal) and 2/15 (jejuno-ileal) patients.
- Vomiting predominated in ileal atresia; abdominal distension in jejuno-ileal atresia. Mortality was 8% (3/36). Anastomotic stricture occurred in 7 patients (3 duodenal, 4 jejuno-ileal).
Conclusions:
- Surgical management included duodeno-jejunostomy for duodenal atresia and bowel resection with anastomosis for jejuno-ileal atresia.
- Jejuno-ileal atresia, attributed to vascular accidents, benefits from ample resection of blind ends.
- Anastomotic stricture is a significant postoperative complication requiring attention.
Abstract:
From 1969 to 1981 duodenal atresia was found in 21 patients and jejuno-ileal atresia in 15 patients. Associated anomalies were revealed in 14 neonates with duodenal atresia and in 2 with jejuno-ileal atresia. Vomiting was the predominant symptom in all patients with ileal atresia except one. Abdominal distension was seen in 2 cases with duodenal atresia and in 11 with jejuno-ileal atresia. The primary surgical procedure was a duodeno-jejunostomy in case of duodenal atresia, and bowel resection with end-to-end anastomosis in jejuno-ileal atresia. Of the 36 patients (8%) died. The cause of death was respiratory insufficiency in one child with duodenal atresia and one with ileal atresia. Another child with ileal atresia died of cardiac malformation. Anastomotic stricture was the most common postoperative complication and was seen in 3 cases with duodenal atresia and in 4 with ileal atresia. As jejuno-ileal atresia is caused by a vascular accident ample resection of the blind ends is recommended.