Sequestered 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 obstruction of intestine due to complete occlusion of the bowel lumen. JIA is most common variety of intestinal atresias followed by duodenal atresia [1,2]. The type-IIIa atresia typically develops due to in-utero volvulus of small bowel, therefore , usually associated with short bowel [1]. Intraute-rine volvulus is the etiology in 25% cases of JIA. As all the cases of JIA, resulted from in-utero volvulus of small intestine, are not associated with malrotation, therefore, in-utero volvulus may develop secondary to the atresia itself where the dilated bowel can twist around its me-sentery. However, atresia can also develop secondary to volvulus even in absence of malrotation. This is especially seen in cases of meconium ileus wherein the me-conium laden loop twists around its mesentery resulting in atresia, peritonitis and/or meconium cyst [3-5]. The sequestered bowel may resorpt partially or completely. Indeed complete resorption occurs in majority, however,