Paediatrics: Small bowel atresias

Small bowel atresias

The incidence of small bowel atresia is 1/3000 live births. The aetiology is thought to be vascular. The pathology of small bowel atresias varies (depending on how deep in the mesentery the vascular accident occurs) from an atresia in continuity with a mucosal membrane to a widely sepa-rated atresia with a V-shaped mesenteric defect and loss of gut (Fig. 23.13). About 10% of atresias are multiple.

Clinical aspects

•   Bile-stained vomiting: babies present shortly after birth with bile-stained vomiting and abdominal distension.

•   AXR shows multiple fluid levels (Fig. 23.14).

•   Laparotomy: end-to-end anastomosis. The prognosis depends on the length of the remaining small bowel.