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

Abstract

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.

Etiology and Outcome of Intestinal Obstruction in Neonates: A 5-Year Investigation of Admitted Cases From a Tertiary Neonatal Intensive Care Unit in Northern Iran

“…The average time for symptoms to appear in our patients was 3.85 days, which is in agreement with most previous studies. 24 , 25 However, our results were contrary to the study reported by Cairo et al, wherein most of the babies presented with intestinal atresia after 7 days of age. 26 This indicates that the onset of presentation in intestinal obstruction is early and it is necessary to pay attention to symptoms, otherwise, it will lead to rapid deterioration of the baby’s condition.…”

Atresia Jejunoileal grau IV em neonato: relato de caso

“…A suspeição diagnóstica durante o pré-natal pode ser feita através da identificação de alças intestinais dilatadas (múltiplas bolhas) e polidrâmnio em ultrassonografia obstétrica. Também podem se apresentar com peritonite meconial e perfuração perinatal 5 . No período pós-natal a investigação diagnóstica pode ser iniciada através de radiografia simples do abdome, enema de contraste e estudo ultrassonográfico.…”