Concomitant Jejunoileal and Colonic Atresias

A full term male baby, weighing 2.9 kg, presented to us with neonatal intestinal obstruction. A routine ante-natal ultrasound had shown dilated loops of bowel. The baby did not tolerate feeds and pass meconium rather developed progressive abdominal distension and bilious vomiting. Abdominal X-ray showed dilated bowel loops. A contrast enema showed micro colon and cut off sign at splenic flexure (Fig. 1). Our preoperative diagnosis was colonic atresia. After resuscitation and optimization, operation was performed that revealed concomitant type I jejunoileal and transverse colon atresias (Fig. 2,3). After excision of 10 cm of dilated proximal jejunum, an end-to-oblique jejunojejunal anastomosis was performed; divided colostomy was done at the level of colonic atresia. Post operative course was uneventful. Patient was discharged on 8th post operative day. The patient had a rectal biopsy done at 6th week followup. Biopsy showed presence of normal ganglion cells. Appointment was given for colostomy reversal.