Immune function and infectious complications in children with jejunoileal atresia

Prachuapthunyachart, Sittichoke; Merani, Shaheed; Cloonan, Madeline R.; Langnas, Alan Norman; Quirós-Tejeira, Rubén E.; Vo, Hanh D.

doi:10.1016/j.jpedsurg.2020.05.036

Cited by 4 publications

(6 citation statements)

References 10 publications

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“…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%

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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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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“…Table (2) shows the descriptive statistics of the types of intestinal atresia, it shows that the most prevalent type is IIIa (28.1%).…”

Section: Resultsmentioning

confidence: 99%

“…The incidence and accompanying abnormalities vary depending on the anatomical site: Duodenal atresia affects around 1 in every 10,000 new-borns and accounts for up to 60% of all small intestinal atresias. Approximately 30 percent of infants with duodenal atresia have a chromosomal anomaly, primarily Down syndrome [2] .…”

Section: Introductionmentioning

confidence: 99%

“…In recent decades, intensive care, surgical treatments, and artificial feeding have all improved the survival rate of most vulnerable infants with congenital Jejunoileal Atresia (JIA).The selection of surgical options aims to ensure that the longest length of the intestine is spared even if it must be passed via numerous anastomoses [2], and duodenal atresia (DA) is a congenital intestinal blockage that affects one in every 5000-10,000 live births and affects males more often than girls [3]. Additionally, more than 50% of babies with DA are found to have an underlying congenital abnormality, such as (vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities) which stand for (VACTERL).…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Intestinal Atresia and Its Complications

Hassan¹

2021

Proceedings of the 1st International Ninevah Conference on Medical Sciences (INCMS 2021)

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Intestinal atresia occurs as 1.3 to 3.5 cases per 10,000 live births, and the understanding of the factors associated with occurrence and complications of intestinal atresia. The current study's goal is to evaluate the various forms of intestinal atresia, and factors associated with intestinal atresia and its complications. Thirty-two infants diagnosed with intestinal atresia were included in the current study. The study was conducted at Al-Zahra Teaching Hospital in Al-Najaf city, in Iraq, during the period between October 2018 to March 2021. The results of the current study show most of neonates have gestational age of 36 weeks (37.5%), those with birth weight less than 2.5Kg (75%), those age at presentation between (4-5) days (50%), those with hospital stay (4-7) days (46.9%), male patients (59.4%), those with no associated anomalies (65.6%), those with no complications (68.8%), type is IIIa (28.1%), and finally only (18.8%) of them had died. The results of the current study show the significant relationship between type of intestinal atresia with complications (p value = 0.02). It was concluded that the most common type of jenunoileal atresia is IIIa. There is an association between complications of intestinal atresia and each of: birth weight, gestational age and hospital stay. It was also concluded relationship between type of intestinal atresia and complications.

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“…12 Prachuapthunyachart et al reported that isolated intestinal atresia cases also have an immunodeficiency and associated infectious complications requiring hospitalization. 13 In addition, the rarest form of recurrent multiple atresia in humans, Hereditary Multiple Intestinal Atresia (HMIA), associated with combined immune deficiency, has been linked to the TTC7A (tetratricopeptide repeat domain-7A) gene, although the mechanism of pathogenesis has not yet been identified. 14 Besides intestinal atresia patients, infants with oesophageal atresia and tracheoesophageal fistula were reported to have DiGeorge syndrome, caused by the deletion 22q11.2, a primary immunodeficiency disease.…”

Section: Discussionmentioning

confidence: 99%

Transient hypogammaglobulinemia of infancy and unclassified syndromic immunodeficiencies are highly common in oesophageal atresia patients

Ulman,

Aygün,

Çağlar

et al. 2023

Scand J Immunol

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Due to the high rate of post‐operative sepsis and other infectious complications, a routine immunological screening protocol has been initiated since 2015 in our paediatric surgery clinic for all patients admitted with oesophageal atresia (EA) and warrant a delayed definitive treatment. In our study, we aimed to evaluate the immunodeficiencies in EA patients, by comparing them to healthy age‐matched controls. As a prospective cohort study, EA patients admitted between 2015 and 2022, who had their definitive operation after the newborn period (>28 days of age) were included. On admission, serum concentrations of IgG, IgA, IgM, lymphocyte subset levels, C3 and C4 levels, specific IgG antibody responses against hepatitis B, hepatitis A, measles, varicella zoster were evaluated. The patients were age‐matched with healthy controls to compare the results and followed up until three years of age. If a humoral immunodeficiency was detected, intravenous immunoglobulin treatment was administered before major oesophageal surgery and during follow‐up. 31 EA patients (18 M/13F) with a mean age of 13.3 ± 9.0 months were compared with 40 age‐matched healthy controls. Mean serum IgG levels were found to be statistically lower than controls in all age groups (P < .05). Transient hypogammaglobulinemia of infancy (THI) and unclassified syndromic immunodeficiencies (USI) were found to be strikingly high, accounting for 29.0% and 22.5%, respectively, adding up to 51.5% of EA patients. This is the first study evaluating immunodeficiencies in EA patients found in the reviewed literature. More than half of EA patients that required delayed surgery had humoral immunodeficiency, so preoperative screening and immunology referral may improve patient outcomes.

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Immune function and infectious complications in children with jejunoileal atresia

Cited by 4 publications

References 10 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

Factors Associated with Intestinal Atresia and Its Complications

Transient hypogammaglobulinemia of infancy and unclassified syndromic immunodeficiencies are highly common in oesophageal atresia patients

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