Intestinal atresia is a congenital (present at birth) malformation that involves the complete absence or closure of a part of the intestine. Intestinal stenosis is a narrowing of the intestine that causes partial blockage. Intestinal atresia is common in the duodenum, jejunum and ileum, which make up the small intestine and is rare in the colon. Intestinal atresia accounts for 33 percent of all cases of intestinal obstruction at birth. If not treated promptly, intestinal atresia and stenosis can lead to damage of the intestines. How often does intestinal atresia and stenosis occur? Intestinal obstruction occurs in approximately 1 out of every 1500 live births. What causes intestinal atresia and stenosis? The cause of most types of intestinal atresia is secondary to an in utero vacular accident. Obstruction of the jejunum may occur in response to another congenital anomaly, such as volvulus (a twisting of the intestine), malrotation of the intestine, hernia, intussusception, or abdominal wall defects such as gastroschisis or omphalocele, that can involve strangulation of the small intestine, which interrupts its blood supply. About half of infants born with duodenal obstruction are premature, more than 30 percent have Down's syndrome and 50 to 75 percent have associated anomalies including cardiac, renal, and other gastrointestinal defects.
What are the symptoms of intestinal atresia and stenosis? The symptoms of intestinal atresia and stenosis depend on the cause, where in the intestine the obstruction is and how long the condition is left untreated. The classic symptoms include:
- Failure to tolerate feedings
- Nausea and Vomiting
- Bilious vomiting
- Intermittent, abdominal pain
- Abdominal distention (sometimes)
- Abdominal X-ray:
- lower GI (gastrointestinal) series (also called barium enema) A procedure that examines the rectum, the large intestine, and the lower part of the small intestine. A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an x-ray) is given into the rectum as an enema. An x-ray of the abdomen shows strictures (narrowed areas), obstructions (blockages), and other problems.
- Abdominal ultrasound - A diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels. Gel is applied to the area of the body being studied, such as the abdomen, and a wand called a transducer is placed on the skin. The transducer sends sound waves into the body that bounce off organs and return to the ultrasound machine, producing an image on the monitor. A picture or video tape of the test is also made so it can be reviewed in the future.
- the extent of the problem
- location of the obstruction
- your child's age, overall health, and medical history
- the opinion of the physicians involved in the child's care
- your opinion or preference
What causes intestinal stenosis?
At one point in gestation, the duodenum is a solid structure. During the 8th-10th weeks of gestation, a vacuolation process occurs whereby the duodenum becomes a hollow structure. Failure of the vacuolation process may result in duodenal atresia and stenosis (Sencan et al., 2002).
Small intestinal atresia/stenosis is more common among multiple gestation pregnancies (Martinez-Frias et al., 2000; Mastroiacovo et al., 1999; Francannet and Robert, 1996; Harris et al., 1995; Cragan et al., 1994; Cragan et al., 1993; Ramos-Arroyo, 1991), although one study reported no association between plurality and small gut atresia (Kallen, 1986).
Edited by Suaviterinmodo, 28 April 2006 - 08:28 PM.