Jejunum atresia

Dolk H. Methylene blue and atresia or stenosis of ileum and jejunum. EUROCAT Working Group. Lancet 1991 338(8773) 1021-2. 

High small bowel obstruction includes atresia or stenosis of the jejunum or proximal ileum. It is now generally accepted that intestinal atresia and ste-... 

Fig. 1.14a,b. Jejunal atresia, a Supine radiograph shows a few dilated, air-filled intestinal loops, about four bubbles , which indicates a high obstruction, b Surgical image demonstrates the location of the atresia (arrow), the dilated proximal jejunum, and the small caliber of the bowel distal to the atresia... 

Fig. 1.16a,b. Jejunal atresia, a Supine radiograph shows an airless abdomen, b Aspiration and insufflation of air through a nasogastric tube was performed and adequately demonstrates the point of obstruction (arrow). Massively dilated loops of jejunum but only about three bubbles give indication of a high obstruction... 

De Backer Al, De Schepper AM, Deprettere A et al (1999) Radiographic manifestations of intestinal obstruction in the newborn. JBR-BTR 82 159-166 De Lorimier A, Fonkalsrud E, Hays D (1969) Congenital atresia and stenosis of the jejunum and ileum. Surgery 65 819-827... 

A distended abdomen is virtually always present the more distal the level of intestinal obstruction. Failure to pass meconium maybe an additional symptom. Atresia of the jejunum and ileum is twice as common as duodenal atresia, about equal in jejunum and ileum, with an incidence of 1 in 4-500 live births. Multiple atresias occur in 10%-20% of cases (Carty et al. 2005 Parker 2003 Grier 1999 Devos and Meradji 2003 Berrocal et al. 1999). Intestinal vascular accidents, such a thromboem-... 

The radiological diagnosis of obstruction is usually visible on the conventional (plain) radiograph. In uncomplicated cases these radiographs of the abdomen are sufficient. The pre-atretic intestinal loops are dilated because of accumulation of large amounts of fluid and fluid levels are usually present on horizontal beam films. In case of jejunal atresia only a few loops of distended jejunum are present in the left upper abdomen, while in ileal atresia many dilated loops are identified. In complicated cases, especially with an abnormally distended and painful abdomen, a colon enema or US can be useful- particularly from the differential diagnostic point of view to exclude meconium ileus or meconium peritonitis. In case of atresia, a microcolon without the presence of meconium is usually found (Devos and Meradji 2003). 

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See also in sourсe #XX -- [ , , ]

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