Case report ileal atresia concurrent with agenesis of the. Imperforate mucosal diaphragm or stringlike segment of bowel very rare 1 per 20,000 live births associated with other congenital anomalies, including hirschsprung disease. During normal fetal development, the intestines remain unobstructed, allowing contents from the stomach to flow freely through the babys digestive tract figure 1. However, up to 1952 the mortality of atresia of the small bowel remained prohibitive even at the best paediatric surgical centres in the world, viz. Though these conditions may involve any portion of the gastrointestinal tract, the small bowel is the most commonly. Most of intestinal atresias are jejunoieal atresia. This has been achieved because of refinements in neonatal intensive care, operative technique, use of total parenteral nutrition tpn, antenatal. The small intestine is divided into three consecutive parts. Secondarily to look at the incidence of reintervention. Mar 15, 2014 atresia yeyuno multiples jejunal atresia dr. Prenatal ultrasonography makes possible an early diagnosis and treatment with better survival. The most common form of intestinal atresia is duodenal atresia. Apr 16, 2019 in all, 62% of atresia and stenosis cases were noted in the jejunum, 30% in the ileum, and 8% in both the jejunum and the ileum. This article will focus on ileal atresia alone but bear in mind that some cases correspond to jejunoileal atresia and show a mixed pattern, including the ones discussed in the jejunal atresia article.
Puede estar afectado cualquier sitio del tubo digestivo, su localizacion mas frecuente es yeyuno e ileon. Duodenal and intestinal atresia and stenosis clinical gate. Intestinal atresia and arthrogryposis, american journal of. Other features include abdominal distension and failure to pass meconium.
Abstract the intestinal atresia is one of the most important causes of intestinal obstruction in newborn. This article will focus on jejunal atresia alone but bear in mind that some cases correspond to jejunoileal atresia and show a mixed pattern, including the ones discussed in the ileal atresia article. Etiology and treatment of small intestinal atresia. Approximately onehalf of the cases involve the duodenum. Intestinal atresia ahtreezha is a term used to describe a broad spectrum of birth defects that result in a blockage in either the small or large intestine. Records of patients of ia admitted in our center from january 2015 to december 2015 were retrospectively analyzed.
The management of neonates with intestinal atresia has improved in recent decades due to refinements in neonatal intensive care, operative technique, use of total parenteral nutrition tpn, and neonatal anesthesia. The site of the atresia can be anywhere from the ligament of treitz to the jejunoileal junction. Fockens 1 of rotterdam reported the first successfully treated case of small bowel atresia. Grandes niveles hidroaereos y abajo una cavidad sin aire. The jejuno ileal atresia is the most usual cause of congenital intestinal occlusion in newborns and the duodenal atresia is the most usual cause of high bowel obstruction in the neonatal period. Ileal atresia results from a vascular accident in utero that leads to decreased intestinal perfusion and subsequent ischemia a segment of bowel. Ileal atresia definition of ileal atresia by medical dictionary. Intrauterine intussusception iui is the one of the rarest recognized causes of jejunoileal atresia jia. During normal fetal development, the intestines remain unobstructed, allowing contents from the stomach to flow freely through the. Intestinal atresia is a broad term used to describe a complete blockage or obstruction anywhere in the intestine. Oct 10, 2016 intestinal atresia ia is one of the most common causes of intestinal obstruction in neonates 1. Intestinal atresia is the main cause of obstruction in the digestive tract in newborn. Prognostic factors in jejunoileal atresia albert einstein. Jejuno ileal atresia is one of the main causes of intestinal obstruction in.
This case report presents a newborn with a bowel obstruction requiring surgery for ileal atresia and malrotation. Hall jg, reed sd, mcgillivra bc, herrmann j, partington mw, schnizel a, shapiro j, weaver dd 1983. Intestinal atresia or stenosis can occur anywhere along the gastrointestinal gi tract, and the anatomic location of the obstruction determines the clinical presentation. A common, sporadic condition with congenital contracture. Jejunoileal atresia is one of the main causes of intestinal obstruction in.
Ileal atresia concurrent with agenesis of the ileocaecal valve and intestinal volvulus in a goat kid. Nowadays the minimally invasive approach has been widely diffused and these surgical options are possible. Susana gonzalez gurrola abril, 2017 atresia intestinal 2. Atresia of the distal ileum concurrent with ileocaecal valve agenesis is one of the rare types of intesti.
The distension is more generalised the further down the bowel the atresia is located and is thus most prominent with ileal atresia. Congenital jejunoileal atresia and stenosis springerlink. Reported survival rates in most of the series from developed countries are 90% or more 24. Heal atresia with total colonic aganglionosis by joseph p janik, eli r. Pdf the intestinal atresia is one of the most important causes of intestinal obstruction in newborn. Small bowel atresia is a type of intestinal atresia classified according to the location along the intestinal tract where the blockage or lack of continuity occurs. Price denver, colorado this is the 17th report of the case of an infant who had ileal atresia associated with hirschsprungs disease, and the second with ganglion cells distal to the atresia. To evaluate the presentation, management, complications and outcome of intestinal atresia ia managed at our center over a period of 1 year. Ileal atresia, malrotation and hirschsprungs disease. The intestinal atresia is one of the most important causes of intestinal obstruction in newborn. Ileal atresia associated with malrotation is rare, but the additional diagnosis of hirschsprungs disease hd in the same patient has not been described in the literature.
The survival rate has improved to 90% in most of the series with the operative mortality being pdf elaborado por medigraphic intestinal atresia abstract introduction. Intestinal atresia occurs in around 1 in 3,000 births in the united states. Intestinal atresia is a wellrecognized cause of bowel obstruction in the newborn. Intestinal atresia and stenosis treatment, diagnosis, and. Ileal atresia definition of ileal atresia by medical. An atresia is a congenital defect of a hollow viscus that results in complete obstruction of the lumen. Inability to pass stool is most common with duodenal. Jorge godoy lenz cirugia laparoscopica en ninos pediatric laparoscopic surgery.
Intestinal atresia and stenosis treatment, diagnosis. Intestinal atresias can occur at any portion of the intestinal tract and are named for the location of the blockage. Jejunal atresia nord national organization for rare disorders. We report on a 15day old fullterm neonate presenting with features of intestinal. Introduction jejunoileal atresia is the most common cause of congenital intestinal occlusion in newborns and the duodenal atresia is the most common cause of high bowel obstruction in the neonatal period. They constitute aorund 95% of total intestinal obstructions in this age group. The outcome of intestinal atresia following surgical repair is very good. An increased mortality is observed in multiple atresias 57%, apple peel atresia 71%, and when atresia is associated with meconium ileus 65%. The opening between the stomach and the small intestine is called the pylorus. Intestinal atresia accounts for about one third of all cases of neonatal intestinal obstruction.
Stenosis refers to a partial obstruction that results in a narrowing of the opening lumen of the intestine. Congenital duodenal atresia and stenosis is a frequent cause of intestinal obstruction and occurs in 1 per 5000 to 10,000 live births, affecting boys more commonly than girls. Ileal atresia is a congenital abnormality where there is significant stenosis or complete absence of a portion of the ileum. Most blockages occur in the small intestine known as jejunal atresia, or ileal atresia but may also occur in the large intestine. There is an increased incidence in those with chromosomal abnormalities. Ileal atresia with total colonic aganglionosis sciencedirect.
Microcolon associated with multiple ileal atresia in a. Intrauterine intussusception iui is the one of the rarest recognized causes of jejuno ileal atresia jia. The most prominent symptom of intestinal atresia is bilious vomiting soon after birth. Primarily to study morbidity and mortality in jejuno ileal atresias jia and prognostic factors for outcome. In most cases, prenatal diagnosis is possible thanks to ultrasound monitoring of the pregnancies. Most newborns with intestinal obstruction present with abdominal distention and bilious emesis in the first 2 days of life, though the presentation can be delayed for weeks in infants with stenosis.
This leads to narrowing, or in the most severe cases, complete obliteration of the intestinal lumen. In general, intestinal atresia refers to atresias of the small intestine jejunum and ileum. Intestinal atresia is one of the most frequent causes of bowel obstruction in the newborn and can occur at any point in the gastrointestinal tract. Demographic data, antenatal history, presenting complaints, location duodenal, jejunoileal, colonic of.918 1181 244 48 39 715 1306 426 1066 253 17 6 219 891 870 872 729 943 952 1402 1041 157 1214 351 383 1356 1246 585 1268 930 1384 1606 1101 1218 656 112 302 1330 1073 570 506 1014 317