Atresia intestinal

INTRODUCTION: Jejunoileal atresia (JIA) is a major congenital anomaly that requires surgical intervention in the neonatal period. During follow-up after surgery, there is usually a period of catch-up growth (CUG) that is sufficient for patients to regain normal weight for age. However, in some cases, CUG is inadequate. The aim of this study was to assess postoperative JIA patients to determine factors that may be associated with good CUG. MATERIAL AND METHODS: We retrospectively reviewed JIA patients treated at our institution by classifying them into three groups based on a comparison of postoperative weight with standard weight for healthy matched controls; that is, more than mean at 12 months after surgery (group M+), less than mean at 12 months after surgery but more than mean at 24 months after surgery because of CUG (group M-CUG+), less than mean at 24 months after surgery because there was no CUG (group M-CUG-)...

PURPOSE: Management of colonic atresia is contentious, with primary anastomosis having a notable risk of anastomotic leak. In addition, resection of the terminal ileum and ileocecal (i-c) valve is frequently performed, risking side effects such as diarrhea, vitamin B(12) deficiency, and gall stone formation. METHODS: The hospital coding system was searched for all patients with a diagnosis of colonic atresia between July 2005 and July 2008. Four term neonates were managed by formation of an ileostomy, a "blow hole" stoma just proximal to the atresia, and a mucus fistula distal to the atresia...

BACKGROUND: Jejunal atresia with short bowel syndrome is an unusual type of jejunoileal atresia. They present with jejunal atresia near the ligament of Treitz and a foreshortened small bowel. In this paper, we report our preliminary experience to emphasize the advantages and feasibility of enteroplasty for intestinal lengthening and primary anastomosis with an anterior flap in jejunal atresia with short bowel syndrome in neonates. METHODS: Between January 2014 and December 2014, four neonates with jejunal atresia and short bowel syndrome were submitted to this procedure in our hospital...

Objective This report documents the authors' experiences in the management of "complex" jejunoileal atresia (JIA) and provides a review of the recent literature on "simple" and "complex" JIA. Materials and Methods This is a retrospective study of eight cases of "complex" JIA managed at the Pediatric Surgical Unit of Infermi Hospital in Rimini from 2002 to 2012. The inclusion criteria are all cases of JIA associated with distal bowel deformities and Types IIIb or IV...

BACKGROUND: Multiple intestinal atresia (MIA) presents with a wide spectrum of bowel pathologies. Its treatment is a challenging task since restoration of anatomical continuity of the affected intestine must be balanced against preservation of the intestine's maximal length. MATERIAL AND METHODS: A retrospective analysis of the medical notes of 26 patients with MIA treated over a 20-year period between 1986 - 2006 was undertaken with a special emphasis on the clinical and surgical perspectives...

PURPOSE: In this study, the authors review cases of jejunoileal atresia (JIA) to evaluate their surgical treatment strategy. METHODS: Eighty-eight neonates who underwent surgical repair for JIA were divided into four groups for the type of lesion: group 1, membranous (n = 23), group II, interrupted (n = 49), group III, multiple (n = 9), and group IV, apple-peel (n = 7). Group I patients were treated with membranectomy or bowel resection and anastomosis, group II with resection of the dilated bowel and one anastomosis, group III with two to six multiple anastomoses to preserve bowel length, and group IV with minimal bowel resection and bowel anastomosis...

OBJECTIVE: Primarily to study morbidity and mortality in jejuno-ileal atresias (JIA) and prognostic factors for outcome. Secondarily to look at the incidence of reintervention. METHODS: Retrospective review of 63 patients diagnosed with JIA over a 30-year period (1975-2005). RESULTS: Sixty-three patients (34 male) of mean gestational age 36 weeks and mean birth weight 2,858 g with JIA were studied. There were 14 type I, 14 type II, 16 type IIIA, 9 type IIIB, and 10 type IV atresias...

OBJECTIVE: To review our management of intestinal atresia (AI). MATERIAL AND METHODS: A retrospective review of patientes with AI, from 1995 to 2011. RESULTS: AI was identified in 41 patients, 29,2% had maternal polyhydramnios and 48,7% were diagnosed prenatally. Four of them had Down Syndrome and 18 had cardiopathy. Duodenal atresia-stenosis (AD) was present in 21 patients, that were treated by 19 duodenoduodenostomy, 1 duodenojejunostomy and 1 duodenotomy with duodenal membrane resection...

BACKGROUND: Supra-Transumbilical Laparotomy (STL) has been used in paediatric surgery for a broad spectrum of abdominal procedures. We report our experience with STL approach for small bowel atresia repair in newborns and review previous published series on the topic. PATIENTS AND METHODS: Fourteen patients with small bowel atresia were treated via STL approach at our Institution over a 5-year period and their charts were retrospectively reviewed. RESULTS: STL procedure was performed at mean age of 3...

The serial transverse enteroplasty procedure (STEP) was introduced as a bowel-lengthening procedure to reduce complications related to short bowel syndrome (SBS). Although some have described it as a useful adjunct to the Bianci procedure, others have acknowledged it as a primary procedure. We present a case of jejunal atresia in which two STEP procedures were performed 7 months apart to increase small bowel length. A 1-day-old, term girl presented with a known bowel obstruction diagnosed in utero. A laparotomy revealed a Type IIIb jejunal atresia with no remaining small bowel or cecum...

Apple-peel atresia (or Type-IIIb intestinal atresia) is an unusual type of jejunoileal atresia. They present with jejunal atresia near the ligament of Treitz and a foreshortened small bowel. Many surgical options have been used, but the optimal method of repair remains unclear. We present a case of a newborn with apple-peel intestinal atresia managed by enteroplasty for intestinal lengthening and primary anastomosis.

OBJECTIVES: Intestinal atresia is a common cause of intestinal obstruction in neonates. The predominant cause of late complications in these children is prolonged dependence on parenteral nutrition (PN). Our aims were to analyze the outcomes for patients with intestinal atresia at our institution, and to see how these changed with the implementation of an intestinal rehabilitation program (IRP). METHODS: This is a retrospective cohort study. The patient population is all children with intestinal atresias (118 patients) treated at our institution from July 2000 to June 2010, 20 of whom became PN dependent...

BACKGROUND: Jejuno-ileal atresia is one of the main causes of intestinal obstruction in neonates. The origin is vascular accidents in the fetal intestine. It is an entity that requires early and specialist management. OBJECTIVE: to know the factors related to mortality in neonates with jejunoileal atresia. METHODS: Case-control nested in a cohort design, comparative study during ten years, between deceased and survivors analyzing factors related to mortality before surgery and during surgery and in the postoperative course...

PURPOSE: Jejunal-ileal atresias are the most common causes of intestinal occlusion in neonatal period. Treatment is classically performed by a right upper quadrant transverse laparotomy. Our study aimed to present our initial experience of intestinal atresia in newborn treated with laparoscopic assisted approach. METHODS: Overall 35 small intestinal atresias, which occurred in infants from September 2009 to July 2012 in our hospital, were treated by laparoscopy-assisted procedure...

INTRODUCTION: Neonatal intestinal atresia surgery requires careful assessment of bowel patency, resection of the affected bowel and a diligent anastomosis. Traditional anastomosis with sutures via a laparoscopic approach would lengthen the surgical time. Various minimally invasive techniques have been reported for neonatal surgery. Our technique offers improved benefits of laparoscopy while observing good principles of surgery. MATERIALS AND SURGICAL TECHNIQUE: Using a three-port approach to aid careful laparoscopic inspection of the bowel, we performed laparoscopy-assisted neonatal intestinal atresia repair in three term neonates with no cardiorespiratory compromise...

BACKGROUND: The dilated bowel segment usually involves the entire jejunum, as well as the duodenum in patients with high jejunal atresia. Classical approaches with a limited tapering enteroplasty and anastomosis frequently fail to restore intestinal function. A novel technique using duodenal derotation and extent tapering jejunoplasty (DDETJ) is reported here. METHODS: Infants with high jejunal atresia within 10 cm of the ligament of Treitz treated with DDETJ over a 3-year period were reviewed...

OBJECTIVE: To describe the outcomes of 130 intestinal atresias between 1982 and 2007. METHODS: Records were analyzed for location, demographics, prenatal diagnosis, birth weight, associated anomalies, surgery, establishment of oral intake, re-interventions and mortality. Statistical analyses were performed using Fisher test and ANOVA. RESULTS: There were 59 duodenal (30 male), 63 jejuno-ileal (34 male) and 8 colonic atresias (3 male). Prenatal diagnosis was established in 27 (46%) duodenal (DA), 26 (41%) jejuno-ileal (JIA) and 1 (12...

PURPOSE: The recovery of gastrointestinal function following surgery for congenital intestinal atresias can be prolonged and may increase morbidity and hospital stay. This study was conducted to investigate the prokinetic effect of erythromycin in neonates undergoing surgery for small bowel atresias. METHODS: A randomized-controlled trial was conducted at the Departments of Paediatrics and Paediatric Surgery, Military Hospital, Rawalpindi, Pakistan, from January to December 2007 to study the prokinetic effect of erythromycin (3 mg/kg per dose 4 times daily)...

Multiple jejunoileal atresia is a challenge to the pediatric surgeon. The aim of the study is to preserve bowel length and prevent the long-term complications of short bowel syndrome. The authors present a rare case of combined multiple jejunoileal atresia and colonic atresia managed by 9 primary anastomoses over a gastroperineal transanastomotic tube. This technique avoided the use of stomas and their attendant complications.

BACKGROUND: Despite improvements in care, intestinal atresias are associated with prolonged hospitalization and occasionally mortality. Although each type of atresia is distinct, it is unclear which factors impact clinical course. This study seeks to identify predictors of untoward outcome. METHODS: Neonates with duodenal, jejunal/ileal, and colonic atresia, treated at 1 institution from 1982 to 2005 were reviewed. Data were evaluated using nonparametric analysis of variance and logistic regression...