Adv Pediatr Surg.  2023 Dec;29(2):89-99. 10.13029/aps.2023.29.2.89.

Jejunoileal Atresia: A Contemporary Review

• Oh C

• KMID: 2551549
• DOI: http://doi.org/10.13029/aps.2023.29.2.89

Abstract

Jejunoileal atresia (JIA) is a rare congenital disorder in newborns leading to intestinal obstruction, necessitating urgent surgery. A delay in diagnosis can result in severe complications like sepsis, bowel perforation, and even death. Over the years, improvements in neonatal care, surgical techniques, and nutrition have led to a marked decrease in mortality rates for JIA patients. While the exact cause remains uncertain, it is thought to result from an ischemic insult during later in utero. JIA is categorized into 4 types, detailing the structure and implications of each type. Clinically, mothers may exhibit polyhydramnios, and infants usually present with symptoms like bilious vomiting and abdominal distension. A significant percentage of affected infants do not pass meconium within the first day of life. Diagnosis is commonly through abdominal radiographs, with some cases requiring contrast enemas. Once diagnosed, immediate surgery is advised, with the primary goal to restore intestinal function and length. Nowadays, the survival rate for JIA patients exceeds 90%. This improvement is attributed to a better understanding of the condition, advancements in surgical techniques, and the introduction of total parenteral nutrition. The prognosis varies, with short bowel syndrome being a significant factor determining the outcome. Short bowel syndrome’s prognosis depends on the remaining small bowel length, the ileocecal valve’s presence, and dependence on long-term nutrition. In conclusion, the treatment and prognosis for JIA have seen substantial improvements due to advances in medical care. Early diagnosis and intervention are crucial. While many patients lead a normal life, those with complications like short bowel syndrome may require long-term care. Future efforts should emphasize refining surgical techniques, gaining a deeper understanding of JIA, and enhancing postoperative care. There's also a need for more research into JIA’s genetics and etiology.

Keyword

Intestinal atresia; Congenital disorder; Newborn; Intestinal obstruction