Background: Intestinal atresia is a common cause of neonatal intestinal obstruction. Jejunal atresia occurs more frequent than duodenal or colonic atresias while single atresias are most commonly encountered. Jejunal atresia is classified into 4 types: Type I (a mucosal/septal), Type II (a fibrous cord/band), Type III (blind ends are entirely separated without a fibrous cord between them and a large mesenteric defect), and Type IV (combination of atresia type I to III). This study aims to elaborate jejunal atresia in the newborn after resection and end-to-end anastomoses.Case Description: We report three cases of jejunal atresia consists of different types: type IV (first case), type IIIa (second case) and type I (third case). Cases were neonates born with signs of upper gut obstruction. Bile-stained vomiting was reported a few hours after birth and failed to pass meconium in the first 24 hours. Postnatal abdominal X-ray showed dilatation of the gaster and no gas present in the pelvic floor. In the third case, it showed a triple bubble sign on abdominal x-ray and a laparotomy revealed the type of jejuno-ileal atresia. Also, the resection on the atresias and end to end anastomosis were performed. Cases were admitted to neonatal intensive care unit with total parenteral nutrition. The first two cases died due to sepsis, while the third case survived.Conclusion: Jejunal atresia is a rare disease among newborn. All of the patients have provided resection and end-to-end anastomoses, although 2 of them did not survive.Â

Neonatal appendicitis (NA) is an extremely rare acute abdomen condition, moreover, if it is a chronic suppurative one. The definite risk factor of NA is barely unknown. The signs and symptoms are often nonspecific and appear after perforation occurs. Most of the cases were found unexpectedly during surgery suspected as other diagnoses. A 7-day-old male neonate presenting lethargic and hypoglycemia since 1 st day of life. Patient drunk breast milk right after since he was born. Meconium was produced <24 h. On the 3 rd day of hospitalization, he experienced bilious vomiting and abdominal distension, so nasogastric tube was installed. Physical examination revealed decreased bowel sound. Investigation showed leucocytosis, slightly increased procalcitonin and abdominal X-ray showed that gas distribution lasted until third part of duodenum followed by minimal gas distribution in the distal part of duodenum. The patient was suspected as distal duodenum stenosis or proximal jejunum. Intraoperatively, it was found that there was second part duodenum malrotation and open Ladd’s procedure was done. During Ladd’s procedure, a perforated appendix was also found. The histopathology result revealed that it was a chronic suppurative appendicitis. Patient was discharged in good condition 20 days after surgery. NA is a rare condition with nonspecific signs and symptoms which was usually found accidentally during surgery suspected as other diagnoses.

Background: Cholelithiasis in children is uncommon and challenging to diagnose because the patient is often asymptomatic and the clinical feature doesn't clearly depict cholelithiasis or cholecystitis. This case study aims to describe a rare case of cholelithiasis with chronic cholecystitis in a ten-year-old boy.Case Presentation: A ten-year-old boy presented with umbilical pain, nausea, and emesis. Physical examination showed there is no tenderness in all abdominal quadrants with a negative Murphy sign. Laboratory results revealed elevated white blood cell count 20.42x103/?L, elevated erythrocyte sedimentation rate 47.2 mm/hour, normal liver function tests, urine, and stool analysis. He underwent transabdominal ultrasound twice. The latest transabdominal ultrasound showed cholelithiasis, free fluid around the pelvic region due to suspected visceral organ perforation. Laparoscopic cholecystectomy was performed without complication. The result of pathology anatomy examination was chronic cholecystitis. The patient was discharged 3 days after surgery in good condition. The long-term prognosis of the patient was good.Conclusion: Even though the patient is male with good nutritional status (not obese), the patient was in the mean age that was identified as a key contributor to this disease. Ultrasonography examination is a screening modality that is still an excellent diagnostic tool with 95% accuracy even though it is highly operator dependent. Laparoscopic cholecystectomy is a gold standard for management even in children with decreased pain and shorter lengths of stay in the hospital.