Congenital Intestinal Atresia

Abstract

Congenital atresia and stenosis of the intestine, exclusive of the pylorus, rectum and anal canal, is a relatively rare condition, occurring in about 1 of 20,000 infants. We have been able to find mention of more than 500 instances previously reported in the literature, though this number probably does not include all the recorded cases. In this paper we are submitting the report of 2 instances that came under our observation and 15 additional cases from the records of the department of pathology of the University of Minnesota.1In the two cases that we observed, the nature of the condition present was correctly recognized, and both patients were operated on, with the unfortunate lethal ending that usually attends the condition. Many authorities regard atresia of the intestine as an irremediable condition with an invariably fatal outcome. A study of the literature, however, reveals that the infants in nine isolated reported instances survived operation. We should like to bring this encouraging information concerning an otherwise hopeless state before the medical profession in the hope that a ray of optimism may penetrate the cloud of pessimism that enshrouds the treatment for congenital atresia of the intestine. REPORT OF CASESCase 1.-History.-J., a white boy, born on Feb. 4, 1929, was admitted to the University Hospital on February 7, with the history of persistent vomiting, which started twelve hours after a normal birth. The vomitus was brown and had a fecal odor. There had been no bowel movements or urination since birth. An enema had been given, with the return of a pasty stool.Examination.-Examination showed a somnolent infant, with flushed skin and distended abdomen which was painful on palpation. The little finger inserted into the rectum met no obstruction. An enema was given and returned clear. Roentgen examination of the abdomen revealed the presence of gas in the small intestine; when the plate was made in the upright posture, fluid levels were visible (fig. Iß). Barium sulphate given by enema traversed the colon as far as the midtransverse colon, and barium given by mouth left the stomach and was visible in the upper reaches of the small intestine (fig. 1C). These roentgenograms were made during

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