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Nam, Park, Kim, Kim, and Kim: The Experience of Operative Management in Jejunoileal Atresia
Original Article
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2010; 79(4): 300-305.

Published online: 31 October 2010

DOI: https://doi.org/10.4174/jkss.2010.79.4.300

The Experience of Operative Management in Jejunoileal Atresia

So-Hyun Nam, M.D., Se-Yeom Park, M.D.1, Dae-Yeon Kim, M.D.2, Seong-Chul Kim, M.D.2, In-Koo Kim, M.D.2

Department of Surgery, Inje University Haeundae Paik Hospital, Busan, Korea.

1Department of Surgery, Presbyterian Medical Center, Jeonju, Korea.

2Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Corresponding author (kimdy@amc.seoul.kr)

Received 14 May 2010       Accepted 2 July 2010

Copyright © 2010 The Korean Surgical Society

Abstract

Purpose

Intestinal atresia is a common cause of neonatal intestinal obstruction. Recently, the survival rate has been increasing from development of prenatal diagnosis, total parenteral nutrition (TPN) and neonatal intensive care. We evaluated the complication rate and cause of mortality after operative management for jejunoileal atresia.

Methods

We reviewed 62 patients (36 males, 26 females) with jejuno-ileal atresia who underwent operation from 1998 to 2007.

Results

There were 37 patients with jejunal atresia and 25 with ileal atresia. The average gestational age was 256±16.6 days and birth weight was 2,824±620 g. Prenatal diagnosis was performed in 45 patients (72.6%) around gestational age 27 weeks. Within 2nd day after birth, 44 patients (71%) underwent operation. Half of the jejunoileal atresia was type IIIa and type I was in 8, type II was in 3, type IIIb was in 12, and type IV was in 8. The operative treatment was resection & anastomosis in 59 patients and enterotomy & web excision in 3. They started feeding at 12.4±11.5 days after operation on average. The average duration of TPN was 26.7±23.5 days, and the incidence of cholestasis was 30.6%. Hospital days averaged 36.8±26 days. Early complication occurred in 14 patients (intestinal obstruction in 5, sepsis in 4, wound problem in 3, anastomosis leakage in 1, and intraabdominal abscess in 1). Late complication occurred in 7 patients (anastomosis stricture in 4 and intestinal obstruction in 3). There was only one case of mortality due to short bowel syndrome after re-operation for adhesive ileus.

Conclusion

The operation for intestinal atresia was successful and aggressive management contributed to a low mortality rate.

Keywords: Intestinal atresia, Jejunal atresia, Ileal atresia, Neonatal intestinal obstruction

Figures and Tables

Table 1
Clinical characteristics of jejunoileal atresia
jkss-79-300-i001

*GA = gestational age; †VSD+ASD = ventricular septal defect with atrial septal defect; ‡TAPVR = total anomalous pulmonary venous return.

Table 2
Type of atresia and operative method
jkss-79-300-i002

*R&A = resection and anastomosis.

Table 3
Start time of feeding and duration of TPN*
jkss-79-300-i003

*TPN = total parenteral nutrition.

Table 4
Early complication in the hospital
jkss-79-300-i004

*C-line = central venous line.

Table 5
Late complication during follow-up period
jkss-79-300-i005

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