Multiple Jejunal Atresia Research Articles

Diagnóstico molecular de sepsis polimicrobiana en paciente pediátrico: reporte de un caso

El diagnóstico de sepsis polimicrobiana es controvertido, se ha considerado factible en pacientes con antecedentes de intervenciones quirúrgicas, sepsis abdominal, entre otros factores de riesgo. A continuación, se describe el caso de un paciente pediátrico con múltiples hospitalizaciones e intervenciones quirúrgicas por el diagnóstico de base de atresia yeyunal múltiple tipo IV, que produjo sepsis polimicrobiana confirmada por biología molecular y cultivos tradicionales. Es importante considerar la sepsis polimicrobiana en hemocultivos tomados con la técnica correcta, ya que la identificación de patógenos conduce al tratamiento dirigido, aumentando la probabilidad de supervivencia de estos pacientes.

Percutaneous catheter decompression in a neonate with multiple small bowel atresias

The management of infants with multiple intestinal atresia and complex gastroschisis can represent a challenge to the paediatric surgeon. This case report presents a neonate with multiple jejunal atresias in which a percutaneous foley catheter tube inserted to just beyond the duodenojejunal flexure was used effectively for bowel decompression, instead of the formation of a proximal stoma. By utilising this technique, the well documented complications associated with proximal stomas were avoided, bowel length was preserved and the need for further surgery in the infant was prevented. The infant remained well at six months with no complications at follow-up.

Prenatal magnetic resonance and ultrasonographic findings in small-bowel obstruction: imaging clues and postnatal outcomes.

Prenatal small-bowel obstruction can result from single or multiple atresias, and it can be an isolated abnormality or part of a syndrome. It is sometimes the first manifestation of cystic fibrosis. Accurate prediction of the level of obstruction and length of bowel affected can be difficult, presenting a challenge for counseling families and planning perinatal management. To review the prenatal US and MRI findings of small-bowel obstruction and to assess whether fetal MRI adds information that could improve prenatal counseling and perinatal management. We retrospectively reviewed 12 prenatally diagnosed cases of small-bowel obstruction evaluated by both US and MRI from 2005 to 2015. We analyzed gestational age at evaluation, US and MRI findings, gestational age at delivery and postnatal outcomes. The final diagnoses were jejunal atresia (7), ileal atresia (1), cystic fibrosis (3) and combined jejunal and anal atresia (1). Four of the eight with jejunal atresia were found to have multiple small-bowel atresias. Prenatal perforation was noted in three. We identified a trend of increasing complexity of bowel contents corresponding to progressively distal level of obstruction, as indicated by increasing US echogenicity and high T1 signal on MRI. Seven cases of jejunal atresia and one case of ileal atresia demonstrated small ascending, transverse and descending colon (microcolon) with filling of a normal-diameter rectum. In contrast, all three fetuses with cystic fibrosis and the fetus with jejunal-anal atresia demonstrated microcolon as well as abnormal paucity or absence of rectal meconium. Polyhydramnios was present in nine. Eight were delivered prematurely, of whom seven had polyhydramnios. The fetus with jejunal and anal atresia died in utero. Postnatally, three had short gut syndrome, all resulting from multiple jejunal atresias; these three were among a subset of four fetuses whose bowel diameter measured more than 3cm. Eight infants had no further gastrointestinal complications. The presence of multiple atresias was not predicted by prenatal US or MRI. MR provides useful additional information regarding meconium distribution in the small bowel, which helps to clarify the level of obstruction. MR was additionally useful in the assessment of colon and rectal contents, serving as a fetal enema. Abnormally diminished meconium in the rectum suggests cystic fibrosis or combined small-bowel and colonic obstruction, information that is useful in counseling and preparing for postnatal care.

Multiple Jejunal Atresia with Multiple Small Bowel Mesentric Diverticuli

Multiple Jejunal Atresia with Multiple Small Bowel Mesentric Diverticuli

Duodeno-jejunal Atresia with Apple-peel Appearance of the Remaining Ileum: A Rare Association

Intestinal atresia is a common cause of neonatal intestinal obstruction. We present a rare case of duodenal atresia, multiple jejunal atresias, and apple peel appearance of the remaining ileum in a 3-day-old neonate. Multiple jejunal atresias were resected, and a duodenojejunostomy was performed. Although duodenal atresia is believed to result from failure of vacuolation process, this very rare association of duodenojejunal atresia with apple peel appearance of the ileum suggests that some vascular injury occurring during late gestation might also lead to duodenal atresia.

P2.114 Coinfection of Treponema Pallidum and Cytomegalovirus (CMV): A Complicated Case of a Newborn in Hungary

BackgroundAlthough congenital syphilis and congenital CMV infections are preventable they are still the major causes of perinatal mortality and morbidity. Expectant mothers from lower socioeconomical status and intravenous drug users...

A Case of Gastroschisis Associated With Multiple Jejunal Atresia and Colon Atresia

A Case of Gastroschisis Associated With Multiple Jejunal Atresia and Colon Atresia

Concurrent dextrogastria, reverse midgut rotation and intestinal atresia in a neonate

A case of dextrogastria associated with multiple jejunal atresia and inverse rotation of the bowel in a neonate is presented. The management of this rare condition is highlighted with a review of the literature.

Chromosome 22q11 deletion complicated by dissecting pulmonary arterial aneurysm and jejunal atresia in an infant.

Abstract We present an autopsy case of a 46-day-old male infant with chromosome 22q11 deletion, which is considered the primary cause of several diseases, including DiGeorge syndrome and velocardiofacial syndrome. The patient had 2 notable congenital abnormalities: multiple dissecting pulmonary arterial aneurysms distributed in both lungs and multiple jejunal atresia with apple-peel deformity. The former, a very rare pathologic condition especially in infancy, was found incidentally at autopsy and was the primary cause of death. To our knowledge, neither of these lesions has been reported previously in a patient with chromosome 22q11 deletion.

Atresia of the appendix

A 4-day-old black male underwent laparotomy for intestinal obstruction. At surgery, multiple jejunal atresias (type IV) of the jejunum were detected. As an incidental finding, atresia of the appendix was also present. The jejunal atresia was repaired, and resection of the tip of the cecal pole and atretic appendix was performed. Gross and histological examination confirmed the presence of a type IV atresia of the jejunum and a cordlike (type II) atresia of the appendix with inflammatory changes in the tip of the appendix. The boy made an uneventful recovery. Examination of all organ systems did not show any associated findings, and the family history was unremarkable. To our best knowledge, this case represents the first case of atresia of the appendix described in the literature.

Duodenoplasty in the management of duodenal atresia

When the duodenum is congenitally obstructed it becomes distended to varying degrees. Our case of combined duodenal and multiple jejunal atresias indicates the value of duodenoplasty for symptomatic duodenomegaly diagnosed in late childhood. The technique used has restored duodenal motility and is recommended for selective use as part of the primary surgery for duodenal and proximal jejunal atresia.

Familial multiple jejunal atresia with malrotation

Two siblings with multiple jejunal atresia and malrotation of the midgut are reported. In the first, incomplete rotation of the gut was associated with two jejunal atresias and an intraluminal diaphragm. In the second, there was complete failure of rotation of the gut with two jejunal atresias, one of which had a V-shaped mesenteric defect. I am unaware of any previous reports of familial multi level small intestinal atresias with malrotation. Possible reasons for this association are discussed.