Original communication| Volume 69, ISSUE 1, P41-51, January 1971

Etiology and treatment of small intestinal atresia: Analysis of a series of 127 jejunoileal atresias and comparison with 62 duodenal atresias

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      Pathological findings and rarity of anomalies in other systems support an origin of jejunoileal atresia in a late fetal accident to the bowel; incarceration of the physiological umbilical hernia may be a common cause. This contrasts with duodenal atresias which probably arise earlier and have many serious associated anomalies.
      In jejunoileal atresia, the prognosis improves with more distal atresias. “Treatment” grouping as well as “risk” grouping is offered.
      Elective resection of proximal bowel has improved results, but anastomotic problems continue in the smaller babies and an alternative technique should be sought.
      Blind pouch formation with a stasis syndrome has occurred after oblique end-to-end anastomosis.
      Familial incidence of the distinct “apple peel” group of atresias is noted.
      The value of the ileocecal valve is discussed, and a healthy survival with only 22 cm. of jejunum and no ileocecal valve is reported.
      Duodenal atresia results have improved with gastrostomy decompression and trans-anastomotic feeding. Associated anomalies and extremely low birth weight are the main problems in treatment, not anastomotic technique.
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