New successful one-step surgical repair for apple peel atresia

Machmouchi, Mahmoud

doi:10.2147/oas.s25147

Cited by 2 publications

(2 citation statements)

References 5 publications

(5 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Type IIIA atresia is a serious congenital anomaly that affects approximately 1:5,000-10,000 live births. 7,8 This type constituted 5-10% of all small bowel atresia and was first reported by Santulli and Blanc, in 1961. A mesenteric (superior mesenteric artery) ischemic insult to the developing midgut during fetal development after the 11th week of gestation is widely accepted to result in jejuno-ileal atresia, as described by Louw and Barnard from their experimental studies.…”

Section: Discussionmentioning

confidence: 90%

Jejunal atresia in the newborn: three cases after resection and end-to-end anastomoses

Sukewanti¹,

Artana²,

Putra³

et al. 2020

Intisari Sains Medis

View full text Add to dashboard Cite

Background:Â Intestinal atresia is a common cause of neonatal intestinal obstruction. Jejunal atresia occurs more frequent than duodenal or colonic atresias while single atresias are most commonly encountered. Jejunal atresia is classified into 4 types: Type I (a mucosal/septal), Type II (a fibrous cord/band), Type III (blind ends are entirely separated without a fibrous cord between them and a large mesenteric defect), and Type IV (combination of atresia type I to III). This study aims to elaborate jejunal atresia in the newborn after resection and end-to-end anastomoses.Case Description:Â We report three cases of jejunal atresia consists of different types: type IV (first case), type IIIa (second case) and type I (third case). Cases were neonates born with signs of upper gut obstruction. Bile-stained vomiting was reported a few hours after birth and failed to pass meconium in the first 24 hours. Postnatal abdominal X-ray showed dilatation of the gaster and no gas present in the pelvic floor. In the third case, it showed a triple bubble sign on abdominal x-ray and a laparotomy revealed the type of jejuno-ileal atresia. Also, the resection on the atresias and end to end anastomosis were performed. Cases were admitted to neonatal intensive care unit with total parenteral nutrition. The first two cases died due to sepsis, while the third case survived.Conclusion:Â Jejunal atresia is a rare disease among newborn. All of the patients have provided resection and end-to-end anastomoses, although 2 of them did not survive.Â

show abstract

Section: Discussionmentioning

confidence: 90%

Jejunal atresia in the newborn: three cases after resection and end-to-end anastomoses

Sukewanti¹,

Artana²,

Putra³

et al. 2020

Intisari Sains Medis

View full text Add to dashboard Cite

show abstract

“…This tube served as a stent for the anastomosis and made it more feasible for the proximal segment's contents to decompress ( 13 ). Two case reports were published describing the use of Foley’s catheter and T-tube, using transanastomotic feeding tubes in both cases ( 9 , 14 ). Al-Zaiem et al performed a retrospective study on the use of a T-tube in neonatal gastrointestinal surgery over 62 neonates including 34 jejunoileal atresias; however, no specifications on the number of apple-peel cases encountered in his study ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

T-tube enterostomy in the management of apple-peel atresia: A case series from a single center

Rashwan

Kotb

2022

Front. Pediatr.

View full text Add to dashboard Cite

Background and objectiveAlthough complex atresias, such as apple-peel and multiple atresias, comprise a smaller percentage, they are usually associated with a higher incidence of postoperative complications and mortality rate. Contrary to simple atresias where the surgical technique of choice usually entails bowel resection and anastomosis with or without enteroplasty, managing apple-peel atresia remains more sophisticated. Decompressive and functionalizing stomas are sometimes mandatory to overcome problems such as increased wall thickness and the wide disparity among the anastomotic ends. Few reports discussed using tube enterostomy in the management of apple-peel atresia; nonetheless, no previous prospective studies were conducted to discuss its efficacy on a larger population. In this study, we are describing our experience using this technique on 12 patients suffering from apple-peel atresia in our center.MethodsA prospective study was conducted from June 2015 to May 2020, where all children who were found to have apple-peel atresia were included in the study. T-tube was placed through an enterotomy through the dilated proximal bowel, around 10 cm before the anastomotic line, and was kept in place using a double suture (Stamm technique) before closing the anterior face of the anastomosis. The short distal limb of the T-tube was oriented toward the anastomotic line, while the long proximal limb was directed proximally. After finishing the anastomosis, the T-tube was delivered outside the abdominal wall, anchoring the enterostomy along with the proximal dilated jejunum against the anterior abdominal wall.ResultsA total of 12 cases were encountered throughout the period of study. The mean age at operation was 4 days and the mean birth weight was 2700 g. The mean time for starting oral feeding postoperatively and T-tube removal was 8 and 10.5 days, respectively. Cases were discharged after a mean of 22 days. As regards morbidity and mortality, a single case developed skin excoriations at the site of tube insertion and was managed conservatively using topical ointments and another case died from overwhelming sepsis 3 days after the operation.ConclusionT-tube enteroplasty is a safe and feasible option in the surgical management of apple-peel atresia. The main strength of our study is its prospective nature and that it includes apple-peel atresia cases only. However, the main limitation is that a larger sample is needed.

show abstract

New successful one-step surgical repair for apple peel atresia

Cited by 2 publications

References 5 publications

Jejunal atresia in the newborn: three cases after resection and end-to-end anastomoses

Jejunal atresia in the newborn: three cases after resection and end-to-end anastomoses

T-tube enterostomy in the management of apple-peel atresia: A case series from a single center

Contact Info

Product

Resources

About