Jejunoileal Atresia and Stenosis

Abstract

Jejunoileal atresia, defined as a congenital defect in continuity of the bowel, is a common cause of intestinal obstruction in the newborn. The incidence of jejunoileal atresia varies from 1 in 330–400 live births to between 1 in 1500–3000 live births. Jejunoileal occlusions occur more frequently than duodenal or colonic. The management of jejunoileal atresia has been one of the great success stories of pediatric surgery in the twentieth century. Mortality of more than 90% up till 1950 was turned to a >80% survival with a simple change in surgical technique prompted by innovative surgical experiments on dog fetus performed by Barnard and Louw – the first steps in fetal surgery. With improved neonatal and perioperative care, safe anesthesia, refined surgical techniques, and better management of short bowel syndrome, a survival rate of greater than 95% can be expected in well-resourced centers. This chapter describes the current approach to the diagnosis and management of jejunoileal atresia of the newborn.