Congenital atresia of the intestine in a premature infant

Abstract

C ONGENITAL atresia of the gastrointestinal tract is an extremely rare anomaly occurring, according to most esthnates, about once in twenty thousand births. Arnhehn 1 tabulated the results of infants treated surgically and reported in the literature from 1911 to ]943. These eases were in infants ranging in age from one hour to 8 days. All were treated by primary anastomosis. Miller 2 stated that primary anastomosis is tile surgical procedure of choice and that primary ileostomy offered absolutely no chance for recovery. That this attitude is well established as authoritative is borne out by a cursory review of the literature. Erb and Smith 3 reported two eases, one with multiple atresias treated by primary anastomosis. Miller, Grecngaard, Rayeroft, and McFadden also reported successful treatment of two cases in this manner. Duncan, Wearn, Jackson, and Waldron 5 successfully treated multiple atresias in a premature infant by short-circuiting anastomosis. Fieeara and Degen G reported a patient who died of meeonium ]oeritonitis after operation. James R. Judd ~ reported the first sueees:sful ease cured by ileostomy alone. A full-term Chinese female infant showed signs of intestinal obstruction following the first feeding. Surgery w~s done in four stages. Supportive measures in the form of blood, vitamins, antibiotics, and parentcral fluids were vigorously employed. This case finds a close para]lel in the following report in a premature infant treated successfully by primary ileostomy.