Intestinal Atresia

(Pyloric Atresia; Duodenal Atresia; Ilial Atresia; Jejunal Atresia; Colonic Atresia; Atresia, Intestinal)

Definition

Intestinal atresia (IA) is present at birth. It is an area of the intestine that has not formed the right way. In some, the intestine may be fully closed. Food or fluids cannot pass through.

IA can happen in the small or large intestines and may be named by where it is found:

  • Pyloric—just after the stomach
  • Duodenal—first part of the small intestine by the stomach
  • Jejunal—small intestine between the upper and lower parts
  • Ilial—happens in the last part of small intestine
  • Colonic—happens in the large colon

Normal Anatomy of the Intestines
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Causes

It is not clear what causes IA. Low blood flow to the intestines before birth may play a role.

Risk Factors

Some types of IA are due to genes. They tend to happen in people who are related.

The risk of IA is higher in women who are pregnant and:

  • Smoke
  • Use drugs
  • Take certain medicines

Symptoms

A baby may have:

  • Vomiting
  • A sunken belly
  • A swollen belly
  • Lack of a first stool

Diagnosis

IA may cause extra fluid to surround the baby during pregnancy. A prenatal ultrasound will be able to detect it. This may be enough to suspect IA.

After birth, the doctor will review the baby's symptoms. Pictures may be taken. This can be done with an abdominal X-ray.

Treatment

IA cannot be treated until after birth.

Surgery will be done to repair the intestine. Supportive care will be given.

Nutrition Support

Nutrition normally enters the body through the intestines. When the intestines are not working the right way, nutrition will be delivered into the blood stream. The baby will have an IV or small belly button tube. Nutrition will be delivered through the tube before and after surgery.

After surgery, the intestines will need a few days or weeks to heal. Small amounts of breast milk or formula will be slowly introduced to the baby. IV nutrition will support the baby during this time. The IV will be removed when the baby can tolerate enough breast milk or formula.

Remove Gas and Fluids

Fluid and gas can build up in the intestine. They can cause swelling and vomiting. The fluid and gas can cause problems during surgery.

A tube will be passed through the nose and into the stomach. The tube will drain fluids and gas out of the stomach and intestines. This will ease some of the pressure in the abdomen.

Surgery

Surgery will be needed to remove the damaged part of the intestine. The healthy parts will be reconnected. More steps may depend on the amount of intestine that is damaged. A large area may need more than one surgery.

A feeding tube may be placed through the abdomen. This tube will help drain the stomach and provide food.

Surgery in the lower intestine may also need a colostomy. The upper part of the intestine that is left is attached to an opening in the abdominal wall. This will allow waste to pass out of the body and give the lower intestines time to heal.

Prevention

There are no known guidelines to prevent IA.

RESOURCES:

Centers for Disease Control and Prevention
http://www.cdc.gov

Family Doctor—American Academy of Family Physicians
http://www.familydoctor.org

CANADIAN RESOURCES:

About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca

Health Canada
https://www.canada.ca

REFERENCES:

Congenital duodenal obstruction. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/congenital-duodenal-obstruction. Accessed November 5, 2020.

Intestinal atresia. Seattle Children’s Hospital website. Available at: https://www.seattlechildrens.org/conditions/intestinal-atresia. Accessed November 5, 2020.

Intestinal atresia and stenosis. Cincinnati Children’s website. Available at: http://www.cincinnatichildrens.org/health/i/obstructions. Accessed November 5, 2020.

Intestinal atresia and stenosis in children. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/intestinal-atresia-and-stenosis/overview. Accessed November 5, 2020.

Intestinal atresia or stenosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/intestinal-atresia-or-stenosis. Accessed November 5, 2020.

Vinocur DN, Lee EY, et al. Neonatal intestinal obstruction. AJR Am J Roentgenol. 2012 Jan;198(1):W1-10.

Last reviewed September 2020 by EBSCO Medical Review Board Kari Kassir, MD  Last Updated: 11/5/2020