Prognosis of Jejunoileal Atresia Treated by Resection and Anastomosis in the Resource-limited Environment
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
A Background: Jejunoileal atresia is the most common etiology of intestinal mechanical obstruction. Several surgical techniques have been described in the therapeutic approach to this condition. Treatment by resection and anastomosis with or without gastrointestinal tapering remains a life-saving option in our daily practice. The aim of our study was to report the results of the surgical treatment of jejunoileal atresia by resection and anastomosis in the resource-limited environment. Materials and Methods: We carried out a prospective, descriptive study from November 12021, to October 31, 2023, equating to 2 years, in the Pediatric Surgery Department. All the records of newborns aged from day 0 to day 21 with jejunoileal atresia, only treated by resection and anastomosis were included. The parameters studied were age at presentation, sex, gestational age, type of atresia, associated malformations, morbidity, mortality, and follow-up. Results: A total of 10 newborns were treated. The median age at the presentation was 2.2 days (1 to 4 days). The male sex was predominant with a sex ratio of 7:3. Prematurity was reported in two cases. No antenatal diagnosis was reported. The type I atresia according to the Martin classification was most commonly found (5 cases). Inguinoscrotal hernia and Ladd bands were associated in 1 case each. Resection and anastomosis with intestinal tapering was performed in all newborns. Surgical site infection was noted in 1 case. We recorded three death
Abstract
A Background: Jejunoileal atresia is the most common etiology of intestinal mechanical obstruction. Several surgical techniques have been described in the therapeutic approach to this condition. Treatment by resection and anastomosis with or without gastrointestinal tapering remains a life-saving option in our daily practice. The aim of our study was to report the results of the surgical treatment of jejunoileal atresia by resection and anastomosis in the resource-limited environment. Materials and Methods: We carried out a prospective, descriptive study from November 12021, to October 31, 2023, equating to 2 years, in the Pediatric Surgery Department. All the records of newborns aged from day 0 to day 21 with jejunoileal atresia, only treated by resection and anastomosis were included. The parameters studied were age at presentation, sex, gestational age, type of atresia, associated malformations, morbidity, mortality, and follow-up. Results: A total of 10 newborns were treated. The median age at the presentation was 2.2 days (1 to 4 days). The male sex was predominant with a sex ratio of 7:3. Prematurity was reported in two cases. No antenatal diagnosis was reported. The type I atresia according to the Martin classification was most commonly found (5 cases). Inguinoscrotal hernia and Ladd bands were associated in 1 case each. Resection and anastomosis with intestinal tapering was performed in all newborns. Surgical site infection was noted in 1 case. We recorded three deaths due to sepsis in our series. Conclusions: In spite of the limitations inherent to low- and middle-income countries region, our current series shows that it is feasible to achieve the acceptable surgical outcomes in neonatal intestinal obstruction due to intestinal atresia. Rigorous adherence to protocols and improvements in the availability of parenteral nutrition are likely to contribute to optimal outcomes in future.