Jejunoileal Atresia and Stenosis: a study of 50 cases done in Central Teaching Hospital of Pediatric in Baghdad

Abstract

AbstractBackground: Congenital defects in continuity of the intestine are morphologically divided into either stenosis or atresia and constitute one of the most common causes of neonatal intestinal obstruction. Most Jejunoileal atresias result from intrauterine ischemia.Aims of the study: To Criticize and evaluate the surgical procedures that are used in the treatment of jejunoileal atresia & to Identify the postoperative complications.Patients & methods: This study was conducted in Central Teaching Hospital of Pediatric in Baghdad for the period from January 2005 to January 2008. All the patients were under (28) days old that were admitted and followed up under the study group. This study for analyzing (50) neonates with jejunoileal atresia .The number of males were (27) and the number of females were (23) and the ratio of/ male to female is 1.17:1. Results: Thirty one patients (62%) had jejunal atresia while ileal atresia was in(19) patients(38%).The most common type of jejunoileal atresia was type I (30%) of the cases and the second was the type IIIa (20%).The clinical presentation for jejunal atresia was mainly bilious vomiting and occurred in(77%)of the cases, while failure of passing meconeum in the first day of life was the most common presentation in ileal atresia and occurred in (89%) . Conclusions: Jejunal atresia most commonly presents with bilious vomiting while ileal atresia presents with abdominal distension and failure to pass meconium in first day of life. The most common type of the atresia in our study was type I while type IV is the rarest & there are several surgical procedures used in the treatment of atresia but wide proximal resection and end to end anastomosis was the commonest procedure doneRecommendations: Early diagnosis and surgical interference are vital in the management of jejunoileal atresia to reduce postoperative complications especially septicemia.Keywords: Jejunoileal atresia, bilious vomiting, anastomotic leak.