Skip to main content Skip to main navigation menu Skip to site footer

Jejunal atresia in the newborn: three cases after resection and end-to-end anastomoses

  • Ni Made Sukewanti ,
  • I Wayan Dharma Artana ,
  • Putu Junara Putra ,
  • I Made Kardana ,
  • Made Sukmawati ,
  • Kadek Deddy Ariyanta ,


Abstract

Background: Intestinal atresia is a common cause of neonatal intestinal obstruction. Jejunal atresia occurs more frequent than duodenal or colonic atresias while single atresias are most commonly encountered. Jejunal atresia is classified into 4 types: Type I (a mucosal/septal), Type II (a fibrous cord/band), Type III (blind ends are entirely separated without a fibrous cord between them and a large mesenteric defect), and Type IV (combination of atresia type I to III). This study aims to elaborate jejunal atresia in the newborn after resection and end-to-end anastomoses.

Case Description: We report three cases of jejunal atresia consists of different types: type IV (first case), type IIIa (second case) and type I (third case). Cases were neonates born with signs of upper gut obstruction. Bile-stained vomiting was reported a few hours after birth and failed to pass meconium in the first 24 hours. Postnatal abdominal X-ray showed dilatation of the gaster and no gas present in the pelvic floor. In the third case, it showed a triple bubble sign on abdominal x-ray and a laparotomy revealed the type of jejuno-ileal atresia. Also, the resection on the atresias and end to end anastomosis were performed. Cases were admitted to neonatal intensive care unit with total parenteral nutrition. The first two cases died due to sepsis, while the third case survived.

Conclusion: Jejunal atresia is a rare disease among newborn. All of the patients have provided resection and end-to-end anastomoses, although 2 of them did not survive. 

Keywords: Jejunal Atresia Newborn Resection Anastomoses

References

  1. Balanescu R, Topor L, Stoica I, Moga A. Associated type IIIB and type IV multiple intestinal atresia in a pediatric patient. Chirurgia (Bucur). 2013;108(3):407–410.
  2. Sirelkhatim EE, Mohamadain AA, Hamza AA. Small Bowel Atresia in Khartoum Teaching Hospital. Global Journal of Medical Research. 2013;13(6):1-5.
  3. Korkmaz M, Buyukunal SC. Proximal Jejunal Atresia Consist of Two Membranous Septa. The Medical Journal of Kocatepe. 2011;12(2):101-4.
  4. Khalaf AA, Al-Obaidy MA, Khalaf KF. Jejunoileal Atresia A study of 60 cases in children welfare teaching hospital. J Fac Med Baghdad. 2010;52(3):1-4.
  5. Akinola RA, Osuoji RL. Apple Peel Small Bowel, A Review of Four Cases: Surgical and Radiographic Aspects. J Nepal Paediatr Soc. 2011;31(3):227-34.
  6. Amole AOD, Johnson AW, Adesiyum OAM. The diagnostic value of the triple bubble sign in proximal jejunal atresia: a case report. Afr J Med Sci. 2003;32(1):95-8.
  7. Schwartzberg D, Burjonrappa SC. Pseudo Double Bubble: Jejunal Duplication Mimicking Duodenal Atresia on Prenatal Ultrasound. Journal of Neonatal Surgery. 2013;2(4):1-4.
  8. Machmouchi M. New successful one-step surgical repair for apple peel atresia. Open Access Surgery. 2011;4:53-6.
  9. Kurbet SB, Patil HS, Dhaded SM, Bhandankar MR, Mane RS. Apple peel jejunal atresia: Successful management of a rare case. Journal of the Scientific Society. 2012;39(1):29-31.
  10. Louw JH, Barnard CN. Congenital intestinal atresia: Observations on its origin. Lancet. 1955;269(6899):1065-7.
  11. Kshirsagar AY, Desai SR, Nagvekar MA, Vasisth GOP. Apple-peel atresia presenting as foetal intestinal obstruction. African Journal of Paediatric Surgery. 2011;8(2):235-6.
  12. Shahjahan M, Ferdous KMN, Mitul MAR, Islam MK. Management of Jejunoileal Atresia: Our 5 year Experience. Chattagram Maa-O-Shishu Hospital Medical College Journal. 2013;12(3):52-5.
  13. Sondheimer JM. Gastrointestinal tract. In: Hay WW, Hayward HR, Levin MJ, Sondheimer JM, editors. Current pediatric diagnosis & treatment. 16th ed. New York: The McGraw-Hill Companies, Inc; 2003. p. 614-92.
  14. Dalla Vecchia LK, Grosfeld JL, West KW, Rescorla FJ, Scherer LR, Engum SA. Intestinal atresia and stenosis: a 25-year experience with 277 cases. Arch Surg. 1998;133(5):490–497.
  15. Sahu S, Dhavala SS. Apple-Peel Syndrome A Case of Malrotation with Atresia of Proximal Small Bowel. Ind J Radiol Imag. 2006;16(2):189-90.
  16. Tröbs RB, Tannapfel A. Apple peel small bowel. Imaging case book. J Perinatol. 2009;29(12):832–833.
  17. Das PC, Avabratha KS. Apple Peel Jejunal Atresia in a Neonate: A Rare Cause of Intestinal Obstruction. International Journal of Biomedical Research. 2012;3(2):114-5.
  18. Ekwunife OH, Oguejiofor IC, Modekwe VI, Osuigwe AN. Jejuno-ileal atresia: a 2-year preliminary study on presentation and outcome. Niger J Clin Pract. 2012;15(3):354–357.

How to Cite

Sukewanti, N. M., Artana, I. W. D., Putra, P. J., Kardana, I. M., Sukmawati, M., & Ariyanta, K. D. (2020). Jejunal atresia in the newborn: three cases after resection and end-to-end anastomoses. Intisari Sains Medis, 11(1), 211–215. https://doi.org/10.15562/ism.v11i1.538
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
240

Total
443

Share

Search Panel

Ni Made Sukewanti
Google Scholar
Pubmed
ISM Journal

I Wayan Dharma Artana
Google Scholar
Pubmed
ISM Journal

Putu Junara Putra
Google Scholar
Pubmed
ISM Journal

I Made Kardana
Google Scholar
Pubmed
ISM Journal

Made Sukmawati
Google Scholar
Pubmed
ISM Journal

Kadek Deddy Ariyanta
Google Scholar
Pubmed
ISM Journal