Open Access, Peer-reviewed
pISSN 2288-6575
eISSN 2288-6796
    J Korean Surg Soc. 2010 Oct;79(4):300-305. Korean.
    Published online Oct 31, 2010.
    https://doi.org/10.4174/jkss.2010.79.4.300
    Copyright © 2010 The Korean Surgical Society
    Original Article

    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 and 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 (Email: kimdy@amc.seoul.kr )
    Received May 14, 2010; Accepted July 02, 2010.

    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

    Tables

    Table 1
    Clinical characteristics of jejunoileal atresia

    Table 2
    Type of atresia and operative method

    Table 3
    Start time of feeding and duration of TPN*

    Table 4
    Early complication in the hospital

    Table 5
    Late complication during follow-up period

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    MeSH Terms
    Abscess
    Adhesives
    Birth Weight
    Cholestasis
    Constriction, Pathologic
    Gestational Age
    Humans
    Ileus
    Incidence
    Infant, Newborn
    Intensive Care, Neonatal
    Intestinal Atresia
    Intestinal Obstruction
    Male
    Parenteral Nutrition, Total
    Parturition
    Prenatal Diagnosis
    Sepsis
    Short Bowel Syndrome
    Survival Rate
    Metrics
    Share
    Tables
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