Small intestinal atresia
| Classification according to ICD-10 | |
|---|---|
| Q41.1 | Congenital absence, atresia and stenosis of the jejunum |
| Q41.2 | Congenital absence, atresia and stenosis of the ileum |
| ICD-10 online (WHO version 2019) | |
The small intestinal atresia describes a developmental disorder of the small intestine belonging to the intestinal atresia , in which the lumen of the jejunum or ileum is not open. This is due to either a membrane or a lack of part of the intestine.
frequency
A frequency of 1.3 in 10,000 is reported in Spain and Latin America.
to form
The jejunum and ileum are equally affected, the proximal jejunum in 31%, distal in 20%, the proximal ileum in 13% and distal in 36%. Usually there is only one atresia, but 6–20% have multiple atresia ( atresia-multiplex-congenita syndrome ).
Classification
The current classification can be found under intestinal atresia # classification .
Symptoms
The food cannot be transported further in the infant's intestine, so the children usually vomit biliously. Immediately after delivery, the children often appear healthy. As the disease progresses, vomiting occurs.
Diagnosis
Atresia of the small intestine can be suspected prenatally through an ultrasound examination if enlarged intestinal loops are constantly visible. A hydramnios may also be present.
After birth, an abdominal x-ray is taken if small intestinal atresia is suspected. A contrast medium exposure is sometimes necessary for further clarification.
therapy
If small intestinal atresia is suspected, the child is fasted and a nasogastric tube is placed. After confirming the diagnosis and stabilizing the child, the operation is performed.
The ends of the intestines are sewn together if possible. If the difference in the width of the upper and lower parts of the intestine is too great, it may be necessary to narrow the upper part or create an anus .
The operation is usually open; H. with an abdominal incision. Minimally invasive therapy is usually not possible, particularly in the case of jejunal atresia.
After the operation, the child is monitored intensively. It is best to feed with breast milk, the amount is increased slowly. In the case of extreme enlargements in the upper part of the intestine, it can take several weeks for the child to be able to absorb all of the food through the gastrointestinal tract.
forecast
If there are multiple or long atresias, short bowel syndrome can occur.
literature
- LM Wessel, J. Fuchs, U. Rolle: Correction of congenital malformations in pediatric surgery. Treatment of diaphragmatic hernia, esophageal atresia, and small intestinal atresia. In: Deutsches Ärzteblatt Int 2015, Vol. 112, pp. 357–64. DOI: 10.3238 / arztebl.2015.035
- K. HELMKE, B. STÖVER and MA LASSRICH: Small intestine In: W. Schuster, D. Färber (editor): Pediatric radiology. Imaging diagnostics. 2nd edition, Springer 1996, Vol. II, p. 452, ISBN 3-540-60224-0 .
Individual evidence
- ↑ Jaime Shalkow, J Antonio Quiros, Nicholas A Shorter: Emedicine: Small Intestinal Atresia and Stenosis. Retrieved January 24, 2010 .
- ↑ emedicine.medscape
- ↑ Christof Sohn, Sevgi Terkanli, Wolfgang Holzgreve: Ultrasound in gynecology and obstetrics . Georg Thieme, Stuttgart 2003, p. 231 .
- ↑ Klaas MA Bax, Keith E. Georgeson, Steven S. Rothenberg, Jean-Stéphane Valla and CK Yeung: Endoscopic Surgery in Infants and Children . Springer Berlin Heidelberg, 2008, p. 293-297 .
