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Temuan radiologi dalam kelainan kongenital atresia jejunum: serial kasus

  • Listyani Gunawan ,
  • Pande Putu Yuli Anandasari ,
  • Putu Patriawan ,


Background: Jejunoileal atresia is an emergency due to mechanical gastrointestinal obstruction, a rare case with a prevalence rate of 1-3 per 10,000 births. There is no difference in incidence by gender. Delay in treatment results in huge losses in terms of malnutrition, failure to thrive, and even death. These case series aim to evaluate radiological findings in congenital jejunal atresia.

Case Presentation: There were 3 patients with the main complaint of bilious vomiting. These three patients underwent a plain abdominal x-ray examination, obtained a picture of a high total obstruction with a triple bubble picture, or had a dilated picture of the proximal obstruction. Partial obstruction based on plain radiographs in one of the patients was found, followed by an examination of contrast meal which filled smoothly up to the jejunum segment with a windsock appearance. The three cases have been proven through surgery, various types of jejunal atresia were obtained. Intestinal resection was performed, followed by an end-to-end jejunal anastomosis.

Conclusion: Correct diagnosis determines the appropriate treatment for the patient. Plain abdominal radiograph as an initial examination in assessing total or partial obstruction in the jejunum, with a typical triple bubble or dilated bowel segment proximal to the obstruction. The windsock appearance of the jejunal segment on the contrast meal confirms the diagnosis of the jejunal web.



Latar Belakang: Atresia jejunoileal merupakan kegawatdaruratan akibat obstruksi mekanik gastrointestinal, yang merupakan kasus jarang dengan angka prevalensi 1-3 per 10000 kelahiran, tidak ada perbedaan insiden berdasarkan gender. Terlambatnya tatalaksana mengakibatkan kerugian yang besar baik malnutrisi, gagal tumbuh, hingga kematian. Laporan kasus ini bertujuan untuk mengevaluasi temuan radiologi dalam kelainan kongenital atresia jejunum.

Laporan Kasus: Terdapat 3 pasien dengan keluhan utama muntah bilosa. Kemudian dari pemeriksaan foto polos abdomen didapatkan gambaran obstruksi total letak tinggi dengan gambaran triple bubble atau memiliki gambaran dilatasi dari proksimal obstruksi. Obstruksi parsial berdasarkan foto polos pada salah satu pasien, dilanjutkan pemeriksaan contrast meal yang mengisi lancar hingga segmen jejunum dengan windsock appearance. Ketiga kasus tersebut telah terbukti melalui hasil operasi, didapatkan atresia jejunum berbagai tipe. Dilakukan reseksi usus dilanjutkan anastomosis end-to-end jejunal.

Kesimpulan: Diagnosis yang tepat, menentukan tatalaksana yang sesuai bagi pasien. Foto polos abdomen sebagai pemeriksaan inisial dalam menilai obstruksi total atau parsial pada jejunum, dengan gambaran khas triple bubble atau dilatasi segmen usus proksimal dari obstruksi. Windsock appearance segmen jejunum pada contrast meal mempertajam diagnosis jejunal web.


  1. Kimura K, Loening-Baucke V. Bilious vomiting in the newborn: rapid diagnosis of intestinal obstruction. Am Fam Physician. 2000;61(9):2791-2798.
  2. Tang PMY, Leung YCL, Hung JWS, Liu CCW, Chung KLY, Chao NSY, et al. Jejunal web masquerading as intestinal malrotation in a neonate with bilious vomiting: A case report. J Pediatr Surg Case Reports. 2015;3(7):292–294.
  3. Rajendran R, Elsalam H, Hegab S, Mukttash G. Multiple jejunoileal and colonic atresias: Case report and review of the literature. Saudi Surg J. 2014;2(2):66-69.
  4. Wax JR, Hamilton T, Cartin A, Dudley J, Pinette MG, Blackstone J. Congenital jejunal and ileal atresia: natural prenatal sonographic history and association with neonatal outcome. J Ultrasound Med. 2006;25(3):337-342.
  5. Maglinte DD, Kelvin FM, Sandrasegaran K, et al. Radiology of small bowel obstruction: contemporary approach and controversies [. Abdom Imaging. 2005;30(2):160-178.
  6. Janugade H, Agarwal S, Bane P, Patil R, Garje A, Singh V, et al. Windsock Deformity in Jejunal Obstruction. International Journal of Health Sciences and Research. 2014;4(2):226–30.
  7. Dao DT, Demehri FR, Barnewolt CE, Buchmiller TL. A new variant of type III jejunoileal atresia. J Pediatr Surg. 2019;54(6):1257-1260.
  8. Baba AA, Shera AH, Sherwani AY, Bakshi IH. Neonatal intestinal obstruction due to double jejunal web causing Windsock deformity. J Indian Assoc Pediatr Surg. 2010;15(3):106-107.
  9. Abba SM, Ismail A, Hamisu DA. Neonatal intestinal obstruction: A case of jejunal colonic atresia with micro colon. West African Journal of Radiology. 2012;19(1):14–16.
  10. Komuro H, Amagai T, Hori T, Hirai M, Matoba K, Watanabe M, et al. Placental vascular compromise in jejunoileal atresia. J Pediatr Surg. 2004;39(11):1701-5.
  11. Vinocur DN, Lee EY, Eisenberg RL. Neonatal intestinal obstruction. AJR Am J Roentgenol. 2012;198(1):W1-W10.
  12. Atresia PJ. The Triple Bubble Sign: A Neglected Radiologic Feature of Proximal Jejunal Atresia. The Internet J Radiol. 2012;3(1):1–6.
  13. Malhotra A, Lakkundi A, Carse E. Bilious vomiting in the newborn: 6 years data from a Level III Centre. J Paediatr Child Health. 2010;46(5):259-261.
  14. Upadhyaya VD, Kumar B, Gupta A, Naranje K, Singh A. Jejunal Windsock Deformity: A Rare Cause of Incomplete Neonatal Intestinal Obstruction. J Neonatal Surg. 2016;5(4):57.
  15. Lin HH, Lee HC, Yeung CY, Chan WT, Jiang CB, Sheu JC, et al. Congenital webs of the gastrointestinal tract: 20 years of experience from a pediatric care teaching hospital in taiwan. Pediatr Neonatol. 2012;53(1):12-7.
  16. Weledji EP, Monono N, Nana T. Side-to-side Anastomosis after Resection of Atresic Segment is Safe and Effective in the Incomplete Type 1 Jejunal Atresia. Clinics in Surgery-Gastroenterological Surgery. 2020;5(1):1-3
  17. Berrocal T, Lamas M, Gutieérrez J, Torres I, Prieto C, del Hoyo ML. Congenital anomalies of the small intestine, colon, and rectum. Radiographics. 1999;19(5):1219-1236.
  18. Kurbet S, Mane R, Patil H, Bhandankar M, Dhaded S. Apple peel jejunal atresia: Successful management of a rare case. Journal of The Scientific Society. 2012;39(1):29-31.
  19. Bracho-Blanchet E, González-Chávez A, Dávila-Pérez R, Zalles Vidal C, Fernández-Portilla E, Nieto-Zermeño J. Prognostic factors related to mortality in newborns with jejunoileal atresia. Cir Cir. 2012;80(4):345-351.

How to Cite

Gunawan, L., Anandasari, P. P. Y., & Patriawan, P. (2021). Temuan radiologi dalam kelainan kongenital atresia jejunum: serial kasus. Intisari Sains Medis, 12(3), 752–756.




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Listyani Gunawan
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Pande Putu Yuli Anandasari
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Putu Patriawan
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