Jejunal and Ileal Atresias
Jejunal and Ileal Atresias
Jejunal and Ileal Atresias
NEONATAL INTESTINAL
OBSTRUCTION (NIO)
Presenters:
1. Mba John ( Midgut Anatomy)
2. Abdallah Jabir Mariam ( Jejunoileal atresia and stenosis)
3. Abdul Rahim Umar Farouk ( meconium plug syndrome)
OBJECTIVES
1. Midgut anatomy
Blood vessels, nerves and lymphatics
2. Jejunoileal atresia and stenosis
Concept, incidence, etiology, classification, clinical
features, radiographic findings other tests and
management.
3. Meconium plug syndrome
Concept, incidence, etiology, classification, clinical
features, radiographic findings other tests and
management.
Anatomy of the Midgut
Overwiew
Meconium ileus
Long segment Hirschprung disease
Duodenal atresia
POSITIVE DIAGNOSIS
Clinical features
1. Polyhydramnios(20-35%)- first sign of intestinal
obstruction.
2. Abdominal distension(rarely present at birth:12-24hrs).
3. Vomiting(often bilious)
4. Failure to pass meconium in first 24h(approximately 80%)
5. Jaundice associated with unconjugated
hyperbilirubinemia(20-30%)
Radiographic study and other tests
Plain radiographs
1. Multiple air-fluid level in the upright or lateral
decubitus proximal to the obstruction.
2. Patchy calcifications(meconium peritonitis)
3. Pneumoperitonium (intestinal perforation)
Contrast studies and CT
Water soluble enemas(gastrografin and hypaque)
1. Hirschprung’s disease
2. Meconium ileus(right colon usually not dilated
3. Small left colon syndrome
4. Megacystis-microcolon-hypoperistalsis syndrome
5. Visceral neuropathies
6. Neural intestinal dysplasia
Management
THANK YOU
REFERENCES