Problems with diagnostics in newborn having the combined pathology of gastric membrane and intestinal atresia

Abstract

Introduction. Congenital malformations of the gastrointestinal tract (GIT) are one of the most common causes of intestinal obstruction and require urgent surgical care in the neonatal period. In the overall structure of GIT, gastrointestinal defects amount up to 25%. Duodenal atresia accounts for 1 case per 7,000–10,000 newborns; jejunal and ileac atresia - 1 case per 1,000–3,000 newborns. Often, the diagnosis is made antenatal. In most cases, diagnostics of intestinal atresia is not difficult, and treatment is carried out in a timely manner. However, in rare cases, intestinal atresia is combined with other congenital malformations in GIT, for example, stomach or duodenum webs. In such a case, if during the atresia surgical correction, a gastric membrane was not suspected, then in the postoperative period there may be problems with treatment requiring additional diagnostics. As a result, web surgical correction is postponed, and the child’s general state can worsen.Material and methods. The authors discuss two cases and their treatment in newborn children who had membranes in their stomach and duodenum combined with the intestinal atresia.Results. The authors also discuss problems which they faced in the diagnostics and treatment. They give their recommendations how to improve diagnostics in children with combined congenital malformations in their gastro-intestinal tract.Conclusion. The full range of diagnostic measures before surgery and a thorough revision of abdominal organs during surgery are key issues in children with gastric and duodenal abnormalities. Undiagnosed and undetected malformations during the first surgical intervention may require a repeated surgical intervention which can worsen the child’s general state.