A population-based study of the outcome after small bowel atresia/stenosis in New South Wales and the Australian Capital Territory, Australia, 1992-2003

Walker, Karen; Badawi, Nadia; Hamid, Celine; Vora, Amish; Halliday, Robert; Taylor, Claire; Shi, Enyi; Roy, Gérard; Simpson, Erroll T.; Holland, A.J.A.

doi:10.1016/j.jpedsurg.2007.10.028

Cited by 32 publications

(19 citation statements)

References 9 publications

(12 reference statements)

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“…Small intestinal motor activity has been found to be present at 16 weeks of gestation, but coordinated contraction and peristalsis is not established until 36 weeks [14][15][16]. Prematurity and LBW had also been previously shown to be significant predictors of increased mortality of JIA by Walker et al, with term infants having a 98% survival rate compared with 87% for preterm infants [1,9].…”

Section: Discussionmentioning

confidence: 99%

“…Jejunoileal atresia (JIA) is a major cause of neonatal intestinal obstruction, with an incidence ranging from 1.3 to 2.9 per 10,000 live births [1][2][3].With advancement of neonatal intensive care, anesthesia, parenteral nutrition and operative techniques, the survival figure was reported to be around 80% in 1990s [4] and further climbed to more than 90% in the 21st century [1,5]. The operative management depends on the site of the atresia, the specific anatomical findings, associated gastrointestinal tract anomalies and the length of the remaining small bowel.…”

Section: Introductionmentioning

confidence: 99%

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Early Reoperations after Primary Repair of Jejunoileal Atresia in Newborns

et al. 2016

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Aim: To review nine-year experience in managing jejuno-ileal atresia (JIA) by primary resection and anastomosis and identify factors associated with reoperations.Methods: From April 2006 to May 2015, all consecutive neonates who underwent bowel resection and primary anastomosis for JIA were analyzed retrospectively. Patients with temporary enterostomy were excluded. Patient demographics, types of atresia, surgical techniques, need for reoperations, and long-term outcomes were investigated.Results: A total of forty-three neonates were included, in which nineteen (44.2%) of them were preterm and fourteen (32.6%) were of low birth weight. Thirteen patients (30.2%) had jejunal atresia whereas thirty patients (69.8%) had ileal atresia. Volvulus, intussusception and meconium peritonitis were noted in 12, 8, and13 patients, respectively. Eight patients (18.6%) had short bowel syndrome after operation. Ten patients (23.3%) required reoperations from 18 days to 4 months after the initial surgery due to anastomotic stricture (n=1), adhesive intestinal obstruction (n=1), small bowel perforation (n=2) and functional obstruction (n=6). Prematurity and low birth weight were associated with functional obstruction leading to reoperation (p=0.04& 0.01 respectively). The overall long-term survival was 97.7%. All surviving patients achieved enteral autonomy and catch-up growth at a median follow-up of 4.7 years.Conclusion: Long-term survival of JIA after primary resection and anastomosis are excellent. However, patients have substantial risk of early reoperations to tackle intraabdominal complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Early Reoperations after Primary Repair of Jejunoileal Atresia in Newborns

et al. 2016

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“…Although previous studies have presented an increased prevalence of CF in children with JIA [1-4], medical professionals working in the field of neonatology and pediatric surgery may still be unaware of this. Leading textbooks in the field do not mention this association.…”

Section: Introductionmentioning

confidence: 99%

Jejunoileal atresia and cystic fibrosis: don’t miss it

et al. 2012

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BackgroundWhile an increased prevalence of cystic fibrosis (CF) in patients with jejunal atresia and ileal atresia (JIA) has been described previously, it still may not be a practice routine to indicate a sweat test or DNA test for CFTR mutations in newborns presenting with JIA. Leading textbooks do not mention JIA as a possible presenting clinical feature of CF. We describe two cases of JIA with a delayed diagnosis of CF (4 months [post mortem] and 19 months). This led to a retrospective review of all patients with JIA in our hospital. We hypothesised that also in the past although indicated further testing for CF had not always been performed.MethodsOver an 18-year period from January 1991 until December 2008, all cases of JIA in our centre were reviewed (n=50). We compared patients who have been tested for CF (n=18) with patients who have not been tested for CF (n=32), with respect to their patient characteristics, either by logistic regression analysis or a nonparametric test (p<0.05).ResultsOf all 50 patients the proportion of infants actually tested for CF was 18 (36%). A statistical significant difference between the group of patients who were tested for CF versus the group of those who were not tested was found in a higher occurrence of postoperative bilious retention after 7 days (56% versus 25%, respectively), and postoperative complications (78% versus 34%, respectively). CF was confirmed in 4 (8%).ConclusionTesting for CF in newborns presenting with JIA does not appear to be common practice. A timely diagnosis of CF leads to presymptomatic treatment and has beneficial effects on morbidity and mortality. CF should be tested for in all children with JIA. We recommend a sweat test for term children and CFTR DNA testing as a first step for preterm infants. Medical professional awareness may be increased if future editions of leading text books in the relevant fields should include JIA as an indication to follow an appropriate CF-diagnostic algorithm.Trial registrationStatement on reporting of a clinical trial: This article is not based on a clinical trial.

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“…Three types are recognized depending on the level of the obstruction. Duodenal atresia is observed in 50% of cases and is considered to be the result of a lack of revacuolization of the solid cord stage of intestinal development [2,3]. Associated anomalies are frequent, especially cardiac malformations (40%) and Down's syndrome (25%) [4,5].…”

mentioning

confidence: 99%

“…At the distal part of the gut, colonic atresia is a rare entity found in 10% of cases whose origin is still unclear [6]. Jejunoileal atresia represents about 40% of cases and is most often isolated [3,5]. According to the first classic description of Louw and Barnard [7] in 1955, in this form, the obstruction seems to be the consequence of a fetal vascular accident.…”

mentioning

confidence: 99%