B. Intestinal atresia or stenosis
This results from intrauterine vascular insult.
Location. Distal ileum > proximal jejunum > duodenum > colon.
Dilated intestinal loops.
Neonatal history and physical
Symptoms appear shortly after birth for atresia but may take weeks to months for stenosis.
Failure to pass meconium.
Failure to thrive.
A “double-bubble” sign is diagnostic of duodenal obstruction.
Contrast enema may be used to identify a distal intestinal atresia and can also identify obstruction secondary to meconium ileus or meconium plug syndrome.
Ampicillin (50 mg/kg) and gentamicin (2.5 mg/kg) should be given preoperatively.
Primary anastomosis, which may require resection or tapering of the dilated proximal segment.
For duodenal atresia, a duodenoduodenostomy or duodenojejunostomy is created to bypass the obstruction.
Saline should be infused into the distal bowel to rule out synchronous intestinal atresias.