Outcome of Jejuno-Ileal Atresia Associated with Intraoperative Finding of Volvulus of Small Bowel
نویسندگان
چکیده
AIM To compare the outcome of patients with jeuno-ileal atresia (JIA) associated with the intraoperative finding of volvulus of small bowel (group A) with that of JIA without volvulus (group B). MATERIALS AND METHODS It is a retrospective observational study conducted at one of the two units of Pediatric Surgery, in a tertiary care public hospital of India, from January 2001 to December 2010. Hospital records were retrieved and analyzed. During this time period, 65 patients with JIA were operated of which 40 (61.5%) had ileal atresia (IA) and 25 (38.5%) had jejunal atresia (JA). Eleven (16.9%) patients had associated intraoperative finding of volvulus of small bowel (Group A) and were studied and compared with group B- not associated with intraoperative findings of volvulus of small bowel (n=54). The demography, clinical features, operative findings, associated anomalies, anastomotic leakage, and outcome were compared. RESULTS Group A comprising of 6 boys and 5 girls, had 8 IA and 3 JA; one case each of Type 3b and Type 4 JIA was seen. Associated anomalies included meconium ileus (n=2), Down's syndrome (n=1) and malrotation (n=1). Anastomotic leak rate was 75% for IA and 66.7% for JA. The mortality was 91% in Group A, 100% for IA and 67% for JA. Group B comprising of 37 boys and 17 girls, had 32 IA and 22 JA; 2 cases of Type 4 and 1 case of Type 3b JIA was seen. Associated anomalies were malrotation (n=2), meconium ileus (n=1), exomphalos (n=1), gastroschisis (n=1) and ileal duplication cyst (n=1). The anastomotic leak rate for JA was 8/21 (38.1%) and IA was 3/28 (10.7%); persistent obstruction was seen in 3/21(14.3%) JA and 1/28 (3.6%) IA patients. In group B, overall mortality rate was 8/22 (36.4%) for JA and 9/32 (28%) for IA. The morbidity and mortality was significantly higher in group A when compared to group B. CONCLUSIONS JIA associated with volvulus (without malrotation) is a sinister entity with a dismal outcome in our experience.
منابع مشابه
Mesoplasty with Pedanculated Seromuscular Flap in Type IIIb Jejuno-ileal Atresia
Jejuno-ileal atresia occurs as a result of an intra-uterine ischemic insult to the midgut. Type III b (apple peel) or (Christmas tree) deformity consists of proximal jejunal atresia, absence of the superior mesenteric artery, agenesis of the dorsal mesentery, a significant loss of intestinal length and a large mesenteric defect [1]. After the surgery, whether short bowel syndrome is occurred or...
متن کاملSequestered Bowel In A Atresia
A 3-day-old male baby was diagnosed to have proximal small bowel atresia. At operation type-IIIa jejuno-ileal atresia (JIA) was encountered with a jumbled up sequestered bowel-loop-mass. The jejunum was 10 cm and ileum merely 1 cm. The bowel was sequestered on account of volvulus in-utero. Atresia is derived from Greek words " a " (no) and " tresis " (orifice); and refers to congenital obstruct...
متن کاملAscaridial Volvulus: An Uncommon Cause of Ileal Perforation
Ascariasis is a common worm infestation in developing and under-developed countries. It is caused by the ingestion of food contaminated with Ascaris eggs from faeces and is more common in places with poor sanitation. Almost 25% of the world population is infested by Ascaris lumbricoides. Although ascariasis is a chronic disease, it can present as acute abdomen rarely. The wandering nature of As...
متن کاملAnorectal Malformation Associated with Small and Large Bowel Atresias: A Rare Association
Anorectal malformation (ARM) is one of frequent neonatal surgical problem managed in pediatric surgical units. Gastrointestinal malformations are associated in approximately 5% cases of ARM. Some of the common associations are oesophageal atresia and trachea oesophageal fistula, duodenal atresia, hirschsprung`s disease, pouch colon and neuronal intestinal dysplasia [1]. Association of ARM with ...
متن کاملEarly Reoperations after Primary Repair of Jejunoileal Atresia in Newborns
Aim: To review nine-year experience in managing jejuno-ileal atresia (JIA) by primary resection and anastomosis and identify factors associated with reoperations. Methods: From April 2006 to May 2015, all consecutive neonates who underwent bowel resection and primary anastomosis for JIA were analyzed retrospectively. Patients with temporary enterostomy were excluded. Patient demographics, types...
متن کامل