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Heather Borders, MD
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Jejunal Atresia

Case Detail

Anatomy: Gastrointestinal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Vascular
Created: over 4 years ago
Updated: over 4 years ago
Tags: PEDS
Modality/Study Types: DR FL
Activities:
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History

Newborn with vomiting.


Case Images


Diagnosis

Jejunal Atresia

Findings

DR – Multiple dilated proximal small bowel loops.

FL – Contrast enema reveals a microcolon with minimal meconium.

Discussion

Jejunal atresia usually presents with abdominal distention and vomiting. There is often a prenatal history of polyhydramnios. First imaging assessment should be conventional radiographs; “triple bubble” sign can be seen in the upper abdomen with no distal bowel gas. The size of the colon in small bowel atresia is variable and depends on the time that the atresia occurred and the distance of the atresia from the colon (more succus entericus is produced with proximal atresias leading to less significant microcolon).

Jejunal atresia can be classified into 4 types: Type I – Intact mesentery and wall with obstruction secondary to a thin mucosal band. Type II – Intact mesentery with obstruction by variable length of fibrotic bowel. Type IIIa – Interrupted bowel with inverted “V” shaped mesenteric defect. Type IIIb – bowel is foreshortened and variably cannulized with absent mesentery and small or absent superior mesenteric artery.

Jejunal atresias have a strong familial tendency, especially the apple peel type. Jejunal atresia is more associated with other somatic malformations than other bowel atresias.



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