Clinical observations of sporadic cases of MIA confined to the small bowel lend support to the hypothesis of a vascular incident etiology. One-stage restoration of intestinal continuity with preservation of maximal intestinal length should be the basic principle of any operative management of MIA. Despite a relatively high morbidity related to the primary damage of the fetal intestine, excellent results with 100 % survival rates can be obtained. After taking the differences in pathogenesis, anatomical and histological features, and the prognosis for sporadic and hereditary forms of MIA into account, these two entities should be classified separately in a modified classification of intestinal atresia.
A case of congenital obstructed Treitz's hernia presenting with bilious vomiting in a newborn baby girl has been presented. Internal herniation of contents within a peritoneal sac of the right paramesocolic hernia formed abdominal cocoon which simulated volvulus neonatorum. Plain radiographs and contrast studies were helpful in defining the nature and extent of the lesion. The patient underwent exploratory laparotomy, reduction of small bowel contents from the hernial sac forming an abdominal cocoon, Ladd's procedure to correct associated midgut malrotation with incidental appendicectomy uneventfully and recovered well.
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