Journal List > J Korean Surg Soc > v.77(6) > 1011046

TOOLS
Jeong, Choe, Kim, Choi, Heo, Lee, Kim, Cho, Ahn, Hong, Shin, Kim, and Seo: Clinical Considerations of Intestinal Atresia
Original Article
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2009; 77(6): 423-428.

Published online: 4 December 2009

DOI: https://doi.org/10.4174/jkss.2009.77.6.423

Clinical Considerations of Intestinal Atresia

In-Oh Jeong, M.D., Yun-Mee Choe, M.D., Jang Young Kim, M.D., Sun Keun Choi, M.D., Yoon Seok Heo, M.D., Keon Young Lee, M.D., Sei-Joong Kim, M.D., Young Up Cho, M.D., Seung Ik Ahn, M.D., Kee Chun Hong, M.D., Seok Hwan Shin, M.D., Kyung Rae Kim, M.D., Jeong-Meen Seo, M.D.1

Department of Surgery, College of Medicine, Inha University, Incheon, Korea.

1Department of Surgery, College of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.

Corresponding author (gsmee@inha.ac.kr)

Received 8 August 2009       Accepted 22 September 2009

Copyright © 2009 The Korean Surgical Society

Abstract

Purpose

The mortality of intestinal atresia has decreased remarkably owing to prenatal diagnosis, development of diagnosis method, neonatal intensive care, surgical technique, total parenteral nutrition and performing of early surgery. The clinical consideration of our experience about intestinal atresia would be helpful in the understanding of disease.

Methods

We reviewed the clinical presentation, hospital days, diagnosis method, surgical method, postoperative early complication and mortality based on medical records, retrospectively, in 32 cases of intestinal atresia encountered at Inha University Hospital between March 1997 and May 2009.

Results

The involved sites were; duodenum (n=11; 34.4%), jejunoileum (n=20; 62.5%), and colon (n=1; 3.1%). The mean postoperative fasting time was 6.38 days. The postoperative morbidity was 9.4% and mortality was 3.1%.

Conclusion

Complete recovery from intestinal atresia can be insured by prompt diagnosis, early surgery and careful neonatal intensive care.

Keywords: Intestinal atresia, Early diagnosis, Neonatal intensive care

Figures and Tables

Table 1
Incidence
jkss-77-423-i001
Table 2
Gestational age
jkss-77-423-i002
Table 3
Birth weight
jkss-77-423-i003
Table 4
Symptoms
jkss-77-423-i004
Table 5
Diagnostic methods
jkss-77-423-i005

*USG = ultrasonography; †CT = computed tomography; ‡UGIs = upper gastrointestinal series; §BE = barium enema.

Table 6
Other associated anomalies
jkss-77-423-i006

*ASD = atrial septal defect; †VSD = ventricular septal defect; ‡GMH = germinal matrix hemorrhage; §TEF = tracheoesophageal fistula.

Table 7
Types of duodenal atresia
jkss-77-423-i007
Table 8
Types of jejunoileal atresia
jkss-77-423-i008

References

1. 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. 133:490–497.
2. Davenport M, Bianchi A. Congenital intestinal atresia. Br J Hosp Med. 1990. 44:174176178–180.
3. Grosfeld JL, Ballantine TV, Shoemaker R. Operative mangement of intestinal atresia and stenosis based on pathologic findings. J Pediatr Surg. 1979. 14:368–375.
4. Knechtle SJ, Filston HC. Anomalous biliary ducts associated with duodenal atresia. J Pediatr Surg. 1990. 25:1266–1269.
5. Louw JH. Resection and end-to-end anastomosis in the management of atresia and stenosis of the small bowel. Surgery. 1967. 62:940–950.
6. Martin LW, Zerella JT. Jejunoileal atresia: a proposed classification. J Pediatr Surg. 1976. 11:399–403.
7. Touloukian RJ. Diagnosis and treatment of jejunoileal atresia. World J Surg. 1993. 17:310–317.
8. Stoll C, Alembik Y, Dott B, Roth MP. Evaluation of prenatal diagnosis of congenital gastro-intestinal atresias. Eur J Epidemiol. 1996. 12:611–616.
9. Miro J, Bard H. Congenital atresia and stenosis of the duodenum: the impact of a prenatal diagnosis. Am J Obstet Gynecol. 1988. 158:555–559.
10. Hancock BJ, Wiseman NE. Congenital duodenal obstruction: the impact of an antenatal diagnosis. J Pediatr Surg. 1989. 24:1027–1031.
11. Fonkalsrud EW, DeLorimier AA, Hays DM. Congenital atresia and stenosis of the duodenum. A review compiled from the members of the Surgical Section of the American Academy of Pediatrics. Pediatrics. 1969. 43:79–83.
12. Kimura K, Mukohara N, Nishijima E, Muraji T, Tsugawa C, Matsumoto Y. Diamond-shaped anastomosis for duodenal atresia: an experience with 44 patients over 15 years. J Pediatr Surg. 1990. 25:977–979.
13. Nixon HH. An experimental study of propulsion in isolated small intestine, and applications to surgery in the newborn. Ann R Coll Surg Engl. 1960. 27:105–124.
14. DeLorimier AA, Norman DA, Goodling CA, Preger L. A model for the cinefluoroscopic and manometric study of chronic intestinal obstruction. J Pediatr Surg. 1973. 8:785–791.
15. Kimura K, Perdzynski W, Soper RT. Elliptical seromuscular resection for tapering the proximal dilated bowel in duodenal or jejunal atresia. J Pediatr Surg. 1996. 31:1405–1406.
16. Pohlson EC, Hatch EI Jr, Glick PL, Tapper D. Individualized management of colonic atresia. Am J Surg. 1988. 155:690–692.
17. Davenport M, Bianchi A, Doig CM, Gough DC. Colonic atresia: current results of treatment. J R Coll Surg Edinb. 1990. 35:25–28.
18. Escobar MA, Ladd AP, Grosfeld JL, West KW, Rescorla FJ, Scherer LR 3rd, et al. Duodenal atresia and stenosis: long-term follow-up over 30 years. J Pediatr Surg. 2004. 39:867–871.
19. Paterson-Brown S, Stalewski H, Brereton RJ. Neonatal small bowel atresia, stenosis and segmental dilatation. Br J Surg. 1991. 78:83–86.
20. DeLorimier AA, Fonkalsrud EW, Hays DM. Congenital atresia and stenosis of the jejunum and ileum. Surgery. 1969. 65:819–827.
21. Grosfeld JL, Rescorla FJ. Duodenal atresia and stenosis: reassessment of treatment and outcome based on antenatal diagnosis, pathologic variance, and long-term follow-up. World J Surg. 1993. 17:301–309.
22. Coran AG, Eraklis AJ. Atresia of the colon. Surgery. 1969. 65:828–831.
23. Cho WH, Kim JS, Park JS. Clinical features of small intestinal atresia. J Korean Surg Soc. 2000. 59:532–538.
TOOLS
Similar articles