Jejunostomy for enteral trophic feeding in the management of apple-peel intestinal atresia

Abstract

Apple-peel (or Type IIIb) is an unusual and severe type of intestinal atresia that has generally been treated with anastomosis, entailing considerable morbidity. The aim of this case report is to present an alternative management option that allows intestinal adaptation before performing the anastomosis. We present a case of apple-peel atresia, born at 27 weeks, which during surgery presented a large discordance between the duodenum and the atretic segment. A jejunostomy of the distal atretic bowel was performed to initiate enteral trophic feeding and stimulate its growth. At 2 months of life, both anastomotic ends were similar in caliber and a side-to-side anastomosis was performed. Jejunostomy is an alternative management option that allows to perform a deferred anastomosis in better conditions.