Apple‐peel jejunal atresia associated with multiple ileal atresias in a preterm newborn: A rare congenital anomaly

Zvizdić, Zlatan; Popović, Nusret; Milišić, Emir; Mesic, Amira; Vranić, Semir

doi:10.1111/jpc.14793

Cited by 3 publications

(12 citation statements)

References 7 publications

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“…Author details 1 Children's Hospital and Institute of Child Health, Lahore, Pakistan. 2 Nationwide Children's, Columbus, OH, USA. 3 Ibn Sina Hospital, Al-Shuwaikh, Kuwait.…”

Section: Abbreviationsmentioning

confidence: 99%

“…JIA is a pertinent condition in neonates with relatively less associated congenital anomalies; however, there are much more varieties and much more surgical options in the case of JIA. It makes JIA a bit more complicated because of a variety of choice of surgical options [1][2][3]. Also, it is a challenging situation in developing and poor countries because of lack of resources, delayed presentation of neonates, and lack of nursery intensive care unit (NICU) facilities [4,5].…”

Section: Introductionmentioning

confidence: 99%

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Jejunoileal atresia: a case-series of 63 neonates and risk factors to mortality

Saleem¹,

Liaqat

Butt³

et al. 2022

Ann Pediatr Surg

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Introduction Jejunoileal atresia (JIA) among neonates is still a condition which has huge morbidity and mortality, particularly in the developing world. We share a case series of JIA in context of their presentation, management, and outcome. Materials and methods This study was conducted at Children’s Hospital and Institute of Child Health, Lahore, over 1 year. We included all patients presenting with JIA, and their demographic details, presentation, investigations, treatment strategies, and the outcome were noted at a pre-designed proforma. All data were analyzed using SPSS version 26. Results A total of 63 neonates with JIA were included. Most of them (79.4%) presented after 48 h of life, and the mean age at presentation was 5.68 ± 4.75 days. There were 37 male patients (58.7%), and 51 (81%) were full-term. The most common presenting complaint was not being able to pass meconium (88.9%). Type III atresia was the most common subtype (41.3%). Most of them underwent resection without tapering. The mean hospital stay was 12.81 ± 6.53, and it was significantly longer among those who underwent re-exploration (P = 0.034). Twenty-three patients (36.5%) expired within 6 months of follow-up. The only significant factor for mortality was the presence of short bowel syndrome (P = 0.030). All other demographic and management factors did not alter the mortality rate. Conclusion Management of surgical neonates is a difficult job in developing countries with limited resources. There is a high mortality rate of neonates following JIA surgeries, and surgeons in these countries must fight on many fronts to improve the outcome.

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“…Author details 1 Children's Hospital and Institute of Child Health, Lahore, Pakistan. 2 Nationwide Children's, Columbus, OH, USA. 3 Ibn Sina Hospital, Al-Shuwaikh, Kuwait.…”

Section: Abbreviationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Jejunoileal atresia: a case-series of 63 neonates and risk factors to mortality

Saleem¹,

Liaqat

Butt³

et al. 2022

Ann Pediatr Surg

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Section: Apple Core Atresia With Associated Meckel’s Diverticulummentioning

confidence: 99%

“…Atresias resulting in a helical or apple peel formation typically involve cases in which the vascular accident has affected the superior mesenteric artery immediately distal to its origin. 2 The precarious vascularization of the distal small bowel makes operative management quite challenging.…”

mentioning

confidence: 99%

“…2 The segment of small bowel with this type of anatomic aberration typically relies on retrograde flow from the ileocolic or right colic artery to supply the distal small bowel with its necessary blood supply. 2 Apple peel atresia was first described by Santulli and Blanc in 1961, and its management has since remained a subject of debate with various conflicting methods of treatment described in the literature. 3 As APA is quite difficult to manage operatively, historically this condition resulted in significant morbidity and mortality.…”

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confidence: 99%

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Primary Repair of an Apple Peel Jejunal Atresia and Transanastomotic Feeding in a 1.2 Kilogram Preterm Infant

Miles

Rippy

Byers

et al. 2021

The American Surgeon™

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Apple-Peel intestinal atresia: A systematic review

Laconi,

Bischoff,

Michailos

et al. 2024

J Neonatal Surg

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Background: Apple-peel bowel atresia (APA) is rare and thus lacks proper management guidelines. This systematic review analyzes various interventions found in the literature for this type of atresia and highlights the outcomes of each intervention with their complications. Methods: The relevant literature on PubMed, Scopus, Embase, and Cochrane was reviewed from November 2020 to January 2021. Articles published in English, French, Italian, or Spanish between 1990 and 2020, focusing on APA, were included. Data on demography, clinical profile, management provided, time to achieve full feed, length of hospital stay, complications, etc., reviewed. Results: A total of 2495 articles were found, of which only 48 met the inclusion criteria. Among these, 125 patients were treated, with 15 deaths. The most frequently employed intervention was primary resection, with or without tapering, while ostomy creation was less commonly used. The most frequent complication across all techniques appeared to be cholestasis, followed by stenosis of the anastomosis and sepsis. Additionally, there were a total of 7 cases of short bowel syndrome (SBS). Conclusion: The management of apple-peel atresia seems variable in various centers of different countries. The review failed to assess which interventions could lead to faster full enteral feeding. The distal part of the anastomosis must be considered as an active part in the resumption of bowel function.

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Apple‐peel jejunal atresia associated with multiple ileal atresias in a preterm newborn: A rare congenital anomaly

Cited by 3 publications

References 7 publications

Jejunoileal atresia: a case-series of 63 neonates and risk factors to mortality

Jejunoileal atresia: a case-series of 63 neonates and risk factors to mortality

Primary Repair of an Apple Peel Jejunal Atresia and Transanastomotic Feeding in a 1.2 Kilogram Preterm Infant

Apple-Peel intestinal atresia: A systematic review

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