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Type IIIb jejunal atresia

Erdal Türk, Ramazan Soylar, Tulay Akca, Selim Serter, İrfan Karaca
We present a case of venobiliary fistula due to umbilical venous catheter (UVC). UVC was inserted the day before surgery in a newborn who was scheduled for type IIIB jejunal atresia surgery. The UVC was superimposed on the liver. It was noted that the gastric drainage became chylous and increased to 790 and then 1977 mL daily. I.v. contrast tomography with 650 mL contrast showed that the opaque substance was dispersed around the catheter and a venobiliary fistula formed, with the administered fluid accumulating in the duodenum...
June 2015: Pediatrics International: Official Journal of the Japan Pediatric Society
Varun K Bhalla, Walter L Pipkin, Robyn M Hatley, Charles G Howell
The serial transverse enteroplasty procedure (STEP) was introduced as a bowel-lengthening procedure to reduce complications related to short bowel syndrome (SBS). Although some have described it as a useful adjunct to the Bianci procedure, others have acknowledged it as a primary procedure. We present a case of jejunal atresia in which two STEP procedures were performed 7 months apart to increase small bowel length. A 1-day-old, term girl presented with a known bowel obstruction diagnosed in utero. A laparotomy revealed a Type IIIb jejunal atresia with no remaining small bowel or cecum...
August 2013: American Surgeon
Luciano Silveira Onofre, Renato Frota de Albuquerque Maranhão, Elaine Cristina Soares Martins, Camila Girardi Fachin, Jose Luiz Martins
Apple-peel atresia (or Type-IIIb intestinal atresia) is an unusual type of jejunoileal atresia. They present with jejunal atresia near the ligament of Treitz and a foreshortened small bowel. Many surgical options have been used, but the optimal method of repair remains unclear. We present a case of a newborn with apple-peel intestinal atresia managed by enteroplasty for intestinal lengthening and primary anastomosis.
June 2013: Journal of Pediatric Surgery
Roberto Miraglia, Pieralba Catalano, Luigi Maruzzelli, Silvia Riva, Marco Spada, Daniele Alberti, Angelo Luca, Bruno Gridelli
We report successful fluoroscopically guided balloon dilatation of an early postoperative stricture of a jejunoileal anastomosis in a 3-month-old infant who underwent serial transverse enteroplasty for type IIIb apple peel intestinal atresia.
December 2010: Journal of Pediatric Surgery
Vikal C Shakya, Chandra S Agrawal, Pramod Shrestha, Prakash Poudel, Sudeep Khaniya, Shailesh Adhikary
BACKGROUND: Intestinal atresia is a common cause of neonatal intestinal obstruction, and management of this disease in limited setup of a developing country is very difficult. METHODS: This study is a retrospective study of patients with jejunoileal atresias and their postoperative outcome in a teaching hospital in eastern Nepal over a 5-year period. RESULTS: There were 28 children (19 boys and 9 girls). 11 children (39.28%) had jejunal atresia and 17 (60...
2010: BMC Surgery
Shawn D St Peter, Danny C Little, Katherine A Barsness, Daniel R Copeland, Casey M Calkins, Suzanne Yoder, Steve S Rothenberg, Saleem Islam, Kuojen Tsao, Daniel J Ostlie
INTRODUCTION: During repair for duodenal atresia, it has been emphasized that inspection of the small bowel to identify a second atresia is required. The laparoscopic approach for repair of duodenal atresia has been criticized for its limitation to perform this step. Given that duodenal atresia and jejunoileal atresias do not share common embryologic origins, we question the validity of this concern. Therefore, we conducted a multicenter retrospective review of duodenal atresia patients to quantify the incidence of jejunoileal atresia in this population...
November 2010: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
V K Patil, B K Kulkarni, A Jiwane, P Kothari, S Poul
In a series of 19 neonates with small-bowel atresia, 16 were treated by end-to-end linear anastomosis (ELA) without resection and 3 by resection anastomosis (RA). Seven atresias were jejunal, 11 were ileal, and 1 jejunoileal; 3 cases were type II, 12 type IIIa, 3 type IIIb, and 1 type IV. There were 4 deaths, 1 after ELA and 3 after RA. The overall mortality decreased from 68 to 20.80% and for linear anastomosis to 6.25% presumably, because the intestinal contents are propelled along the lumen in a linear fashion and not at an angle as in end-to-back anastomosis, avoiding shearing of the suture line...
November 2001: Pediatric Surgery International
P K Tam, G Nicholls
To assess the prevalence of antenatal diagnosis of small-intestinal atresias (SIA) in the modern era and determine its effect on management and outcome, the records of neonates admitted to a single institution in 1991-1996 with a diagnosis of SIA were reviewed. Duodenal atresia, atresias complicating meconium ileus, and those associated with gastroschisis were excluded. Of 14 neonates with SIA, 10 had jejunal atresia (JA) (Grosfeld type I, n = 1; type II, n = 2; type IIIa, n = 3; type IIIb [apple peel], n = 3; type IV, n = 1) and 4 had ileal atresia (IA) (type II, n = 1; type IIIa, n = 3)...
1999: Pediatric Surgery International
J C Hoehner, S H Ein, P C Kim
BACKGROUND: The incidence of jejuno-ileal atresia in neonates concomitantly found to possess gastroschisis has been reported to be 5% to 25%. Initial treatment for this condition has not been well established. METHODS: Thirteen newborns with gastroschisis and coexisting jejuno-ileal atresia, were identified and treated at our institution over the past 16 years (1978 through 1996). Patient characteristics at presentation, surgical therapy, and complications at extended follow-up were reviewed...
June 1998: Journal of Pediatric Surgery
H Flageole, V R Adolph, D L Sigalet, A Fecteau, E Drouin, J M Laberge
While small-bowel transplantation remains an option for the management of short-bowel syndrome (SBS), every effort must be made to optimize the function of the native bowel. This report describes a patient with SBS who dramatically improved after a Bianchi procedure. The patient was born with type IIIb jejunal atresia, complicated by volvulus of the terminal ileum. He was left with 40 cm of small bowel and his ileocecal valve. During the first 20 months of his life, he was always hospitalized except for 3 months...
December 1997: European Journal of Pediatric Surgery
V Kazandjian, Y Aigrain, G Enezian, M Guillaume, N Boige, I Amiel, G Weisgerber, M Boureau
13 high jejunal atresias, including 6 type IIIb apple peel small bowel deformities, have been treated by a one stage surgical procedure, including proximal jejunal resection, tapering duodenoplasty and end-to-end duodeno-jejunal or duodeno-ileal anastomosis. All 13 infants survived. There were no anastomotic leak or malfunction. 7 jejunal atresias with normal distal small bowel were fed a mean of 9 days post-operatively (range 4 to 12 days). Intra-venous fluids were discontinued at a mean of 18 days post-operatively (range 13 to 24 days)...
1989: Chirurgie Pédiatrique
S G Jolley, J P Kurlinski, J L Unger
The coexistence of biliary atresia and small bowel atresia has been described. However, attempts to correct the biliary atresia at the same time as small bowel atresia repair have not been detailed. In 1986, a 2,170-g female was delivered at 36 weeks' gestation. Postpartum, duodenal obstruction was suspected after oral feedings were not tolerated. At 37 hours after birth, laparotomy showed unsuspected biliary atresia in addition to intestinal malrotation, duodenal web, and type IIIb jejunal atresia with an apple-peel configuration of the upper jejunum and mesentery supplied by the superior mesenteric artery with normal small bowel length and normal ileal mesentery...
December 1992: Journal of Pediatric Surgery
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