Intestinal Atresia Repair—Child

Definition

Intestinal atresia is a birth defect that causes blockages of intestine. This repair is a surgery to removes the damaged area and connect the healthy ends.

Reasons for Procedure

This repair will let food pass through the intestines. It is done to repair the defect which is life threatening. It may take more than 1 surgery to correct the problem if a large area is involved.

Normal Anatomy of the Abdominal Organs

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Possible Complications

Problems from the procedure will depend on the location and size of the defect. The doctor will review potential problems, like:

  • Stop of any intestinal movement (ileus)—leads to back-up
  • Bleeding
  • Infection
  • Leakage from where intestines were reconnected
  • Short bowel syndrome—problem absorbing enough nutrition if a large segment of small intestine was removed
  • Adhesions or scarring, which may cause blockage
  • Vitamin deficiencies
  • Blind loop syndrome–overgrowth of bacteria

What to Expect

Prior to Procedure

Atresia may be found before birth. A plan will be made to make repairs soon after the baby is born. Repairs cannot be made prior to the baby’s birth.

After birth, supportive steps before the surgery may include:

  • IV fluids and nutrition
  • Nasogastric tube to remove excess air and fluid in the stomach and intestines

Anesthesia

General anesthesia is used. The baby will be asleep during the procedure.

Description of the Procedure

A cut will be made in the belly. The damaged intestine will be located and removed. The healthy ends of the intestine will be connected. The cut will then be closed with stitches and/or staples. The incision will then be covered with a bandage.

The intestine may not be able to be reconnected right away. An opening may be made in the skin and belly wall. The upper part of the remaining intestine is attached to this opening. This will form a stoma. The stoma will allow food waste to pass out of the body into an attached bag. This will let the lower intestine heal or lengthen enough to later reconnect.

Future surgeries may be needed once the baby is healthier. The open ends can then be connected or more tissue may be repaired.

Immediately After Procedure

The baby will be taken to a recovery room. The care team will watch for any problems and make sure the child is comfortable.

How Long Will It Take?

It depends on how much repair is needed.

How Much Will It Hurt?

Anesthesia prevents pain during surgery. Medicine will help to manage pain or soreness during recovery.

Average Hospital Stay

The length of stay depends on the extent of the repair needed. Proper feeding, weight gain, and bowel function are needed before the baby can go home. This may take several weeks.

Post-procedure Care

At the Hospital

A neonatal intensive care unit will watch over the baby. Recovery may also include:

  • Pain medicine
  • Antibiotics to prevent infection
  • IV fluids and nutritional support

The hospital staff will take steps to reduce the chance of infection such as:

  • Wash their hands
  • Wear gloves or masks
  • Keep your baby’s incisions covered

There are also steps you can take to reduce your baby’s chances of infection such as:

  • Wash your hands often and reminding visitors and care team to do the same
  • Remind care team to wear gloves or masks when needed.
  • Do not allow others to touch your baby’s incisions

At Home

Recovery may take some time. A special diet may be needed to make sure the baby is getting proper nutrients. The baby’s growth and overall health will be watched to make nutrition is adequate.

Call Your Doctor

It is important to monitor your baby's recovery after they leave the hospital. Alert your baby's doctor to any problems. If any of the following occur, call your baby's doctor:

  • Signs of infection, including fever or chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • New or worsening symptoms

Call for emergency medical service right away if your baby has:

  • Difficulty breathing
  • Signs of bowel obstruction
    • High fever
    • Localized abdominal tenderness
    • Abdominal swelling or hardness
    • Green or yellow vomit

If you think your baby has an emergency, call for emergency medical services right away.

RESOURCES:

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

CANADIAN RESOURCES:

March of Dimes Canada
http://www.marchofdimes.ca
Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References:

Intestinal atresia and stenosis in children. Boston Children’s Hospital website. Available at:
...(Click grey area to select URL)
Accessed January 11, 2019.
Intestinal atresia or stenosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated July 28, 2015. Accessed January 11, 2019.
Surgical repair of the small bowel. The Children’s Hospital of Philadelphia website. Available at:
...(Click grey area to select URL)
Accessed January 11, 2019.
Last reviewed May 2018 by Michael Woods, MD
Last Updated: 1/8/2019

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