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ATRESIA OF THE JEJUNUM AND ILEUM: THE DISTINCTION
Author(s) -
Tongsin A. T.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04125_2.x
Subject(s) - medicine , atresia , intestinal atresia , jejunum , ileum , gastroenterology , anastomosis , perforation , gestational age , surgery , pregnancy , biology , materials science , genetics , punching , metallurgy
Purpose Atresia of the jejunum and ileum is one of the major causes of neonatal intestinal obstruction. Most affected newborn infants present with bilious emesis and abdominal distention. Traditionally, jejunal and ileal atresia have been grouped together as jejunoileal atresia. From our observation and experience, we found many differences regarding clinical features and outcome between these two groups. The purpose of this study is to elucidate the difference between jejunal and ileal atresia. Methodology A retrospective analysis of patients diagnosed with jejunal or ileal atresia during 1991–2005 was carried out. Results There were 68 patients with jejunal atresia and 56 with ileal atresia. The mean birth weight and gestational age of patients with jejunal atresia were significantly lower than those with ileal atresia. Antenatal perforation occurred more frequently in ileal atresia. Postoperative course was more prolonged and mortality was higher in jejunal atresia. Prolonged ileus and anastomotic dysfunction requiring long‐term parenteral nutrition were the major causes of complications leading to death. Conclusion There were many differences between patients with jejunal atresia and those with ileal atresia. The more compliant jejunal wall allows massive dilatation upon obstruction with subsequent loss of peristaltic activity, thus poorer outcome in comparison with ileal obstruction. We suggest that atresia of the jejunum and ileum be considered distinctly.