Small Bowel Atresia in Khartoum Teaching Hospital

Abstract

Introduction: Intestinal atresia is a common cause of neonatal intestinal obstruction. Duodenal atresia occurs most properly due to failure of recanalization of the foregut, while jejuno-ileal atresia is due to intra uterine ischemia. Objectives: To describe the pattern, clinical presentation, surgical treatment and outcome of bowel atresia. Patients & Method: The study was Observational, analytic, hospital based study. Result: Study of 40 patients with small bowel atresia showed that; more than 80% of patients were neonates, males: females’ ratio was 1.4:1. Duodenal atresia was found in 27.5 % while jejunoileal atresia was found in 82.5% (57.5% was jejunal and 15% was ileal). All patients presented with vomiting most of them were bilious. Features of Dawn syndrome reported in four patients, all of them were duodenal (36%), cardiac anomalies occurred in 18% of duodenal atresia. Malrotation was found in three patients one was duodenal and two were jejunoileal. Prematurity occurred in 20% of patients, low birth weight was found in 45%. Duodenal atresia was treated by duodenoduodenostomy, duodeno-jejunostomy or duodenotomy for stenosis. While jejunoileal atresia was treated resection and anastomosis in most of the cases, enteroplasty was done in patients with short bowel, one patient treated by stoma because of perforation and peritonitis. Mortality rate was 32.5% due to multiple causes; cardiac anomalies, jaundice, prematurity and type of atresia were the commonest causes. Conclusion: In our country lack of neonatal intensive care unit and total parenteral nutrition increases the mortality rate, availability of these things plus pre natal diagnosis will improve the outcome.