Congenital leiomyomatous tumor in a newbornsimulating jejunal atresia

Abstract

A newborn girl, a first child with a normal tull-term spontaneous delivery, was noted to spit up bile-stained gastrointestinal contents in the first hours of life. Flat and erect films of the abdomen and then a barium enema were ordered by the pediatrician. The erect film showed a distended stomach and a loop or two of distended upper jejunum (Fig. 1). The barium enema showed a normal colon in normal position. It was felt that the baby had a high jejunal atresia, and she was operated upon at 12 hr of age. At operation there was complete obstruction of the jejunum at about 20 cm from the ligament of Treitz. At this point there was a hard fibrous l-cm mass completely obstructing the jejunum. The intestine proximal to this lesion was dilated, measuring 2.5 cm in diameter, and distally the intestine was very attenuated, measuring about 5 mm in diameter. The remainder of the gastrointestinal tract was normal. The above area was resected and an end-to-side anastomosis carried out. The baby had a completely benign postoperative c ourse and was discharged 1 wk later taking formula well and having normal bowel movements. The baby has continued to do well up to the present time, 15 mo later.