Volume 33, Issue 156 (January & February 2025)                   J Adv Med Biomed Res 2025, 33(156): 68-72 | Back to browse issues page

Ethics code: IR.SSU.MEDICINE.REC.1400.244

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Mirjalili S R, Edalatkhah R, Amouei A, Noorishadkam M, Lookzadeh M H, Ahmadi Bidakhavidi M. Complications and Outcomes in Neonates with Gastrointestinal Atresia: A Study at Shahid Sadoughi Hospital, Yazd. J Adv Med Biomed Res 2025; 33 (156) :68-72
URL: http://journal.zums.ac.ir/article-1-7555-en.html
Complications and Outcomes in Neonates with Gastrointestinal Atresia: A Study at Shahid Sadoughi Hospital, Yazd
Seyed Reza Mirjalili1 , Roohollah Edalatkhah *2 , Abdolhamid Amouei3 , Mahmood Noorishadkam1 , Mohamad Hosein Lookzadeh1 , Mojtaba Ahmadi Bidakhavidi4
1- Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- Hematology and Oncology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , drr.edalatkhah@gmail.com
3- Department of Surgery, School of public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
4- Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract:   (1233 Views)

Backgrounds and Aims: Intestinal atresia stands as a prevalent cause of neonatal intestinal obstruction, necessitating surgical intervention. Given the susceptibility of these patients to complications and potential mortality, this study aims to explore the complications and outcomes associated with intestinal atresias.
Methods: This retrospective cohort study encompassed 59 patients with intestinal atresia evaluated at Shahid Sadoughi Hospital in Yazd between 2016 and 2021. Demographic data, atresia location, concurrent anomalies, complications, and outcomes were documented and analyzed.
Results: 59 patients with intestinal atresia, 22 boys and 37 girls, with a mean gestational age of 36.23 ± 2.61 weeks, were evaluated.Duodenal atresia was present in 39%, jejunal atresia in 28.8%, ileal atresia in 8.5%, colonic atresia in 5.1%, and concurrent jejunal and ileal atresia in 18.6% of cases. The predominant associated anomaly was cardiac (39%). Post-surgery, oral feeding commenced on average by day 8, with a complete transition to enteral nutrition by day 21. Thirty-four neonates (57.6%) necessitated a central venous line for TPN administration, with an average parenteral nutrition duration of approximately 14 days. Early postoperative complications included apnea (32.2%), anastomotic leak (10.2%), sepsis (25.4%), and wound dehiscence and infection (5.1%). Short bowel syndrome developed in 15.3% post-treatment. Late complications involved cholestasis (20.3%), chronic diarrhea (10.2%), chronic constipation (3.4%), and adhesive bowel obstruction (23.7%). The mortality rate was 15.3%, with the highest mortality associated with duodenal atresia (44.4%).
Conclusion: A comprehensive assessment for concurrent anomalies, prompt treatment, and suitable nutritional support prove instrumental in mitigating complications and mortality in patients with intestinal atresia.

Keywords: Intestinal Atresia, Follow-up, Short Bowel Syndrome
Full-Text [PDF 320 kb]   (316 Downloads) |   |   Full-Text (HTML)  (278 Views)  
Type of Study: Original Research Article | Subject: Clinical Medicine
Received: 2024/10/25 | Accepted: 2025/03/2 | Published: 2025/03/13
References
1. Nusinovich Y, Revenis M, Torres C. Long-term outcomes for infants with intestinal atresia studied at Children's National Medical Center. J Pediatr Gastroenterol Nutr. 2013;57(3):324-9. [DOI:10.1097/MPG.0b013e318299fd9f] [PMID]
2. Stollman TH, de Blaauw I, Wijnen MH, van der Staak FH, Rieu PN, Draaisma JM, et al. Decreased mortality but increased morbidity in neonates with jejunoileal atresia; a study of 114 cases over a 34-year period. J Pediatr Surg. 2009;44(1):217-21. [DOI:10.1016/j.jpedsurg.2008.10.043] [PMID]
3. Piper HG, Alesbury J, Waterford SD, Zurakowski D, Jaksic T. Intestinal atresias: factors affecting clinical outcomes. J Pediatr Surg. 2008;43(7):1244-8. [DOI:10.1016/j.jpedsurg.2007.09.053] [PMID]
4. Burjonrappa SC, Crete E, Bouchard S. Prognostic factors in jejuno-ileal atresia. Pediatr Surg Int. 2009;25:795-8. [DOI:10.1007/s00383-009-2422-y] [PMID]
5. Duro D, Kamin D, Duggan C. Overview of pediatric short bowel syndrome. J Pediatr Gastroenterol Nutr. 2008;47:S33-S6. [DOI:10.1097/MPG.0b013e3181819007] [PMID]
6. Escobar MA, Ladd AP, Grosfeld JL, West KW, Rescorla FJ, Scherer III LR, et al. Duodenal atresia and stenosis: long-term follow-up over 30 years. J J Pediatr Surg. 2004;39(6):867-71. [DOI:10.1016/j.jpedsurg.2004.02.025] [PMID]
7. Severijnen R, Bayat N, Bakker H, Tolboom J, Bongaerts G. Enteral drug absorption in patients with short small bowel: a review. Clin Pharmacokinet. 2004;43:951-62. [DOI:10.2165/00003088-200443140-00001] [PMID]
8. Toyama C, Masahata K, Ibuka S, Nara K, Soh H, Usui N. The risk factors for cholestasis in patients with duodenal atresia in a single institutional cohort. Pediatr Surg Int. 2021;37:929-35. [DOI:10.1007/s00383-021-04890-6] [PMID]
9. Mirza B, Sheikh A. Multiple associated anomalies in patients of duodenal atresia: a case series. J Neonatal Surg.. 2012;1(2):23. [DOI:10.1186/1757-1626-1-215] [PMID] [PMCID]
10. Angotti R, Molinaro FR, Sica M, Mariscoli F, Bindi E, Mazzei O, et al. Association of duodenal atresia, malrotation, and atrial septal defect in a Down-syndrome patient. APSP J Case Rep. 2016;7(2):16. [DOI:10.4081/jsas.2015.6470]
11. Morris G, Kennedy A, Cochran W. Small bowel congenital anomalies: a review and update. Curr Gastroenterol Rep. 2016;18:1-2. [DOI:10.1007/s11894-016-0490-4] [PMID]
12. Best KE, Tennant PW, Addor MC, Bianchi F, Boyd P, Calzolari E, et al. Epidemiology of small intestinal atresia in Europe: a register-based study. Arch Dis Child Fetal Neonatal Ed. 2012;97(5):F353-8. [DOI:10.1136/fetalneonatal-2011-300631] [PMID]
13. Peng YF, Zheng HQ, Zhang H, He QM, Wang Z, Zhong W, et al. Comparison of outcomes following three surgical techniques for patients with severe jejunoileal atresia. Gastroenterol Rep. 2019;7(6):444-8. [DOI:10.1093/gastro/goz026] [PMID] [PMCID]
14. Peng Y, Zheng H, He Q, Wang Z, Zhang H, Chaudhari PB, et al. Is the Bishop–Koop procedure useful in severe jejunoileal atresia?. J Pediatr Surg. 2018;53(10):1914-7. [DOI:10.1016/j.jpedsurg.2018.03.027] [PMID]
15. Hemming V, Rankin J. Small intestinal atresia in a defined population: occurrence, prenatal diagnosis and survival. Prenat Diagn. 2007;27(13):1205-11. [DOI:10.1002/pd.1886] [PMID]
16. Calisti A, Olivieri C, Coletta R, Briganti V, Oriolo L, Giannino G. Jejunoileal atresia: factors affecting the outcome and long-term sequelae. J Clin Neonatol. 2012;1(1):38-41. [DOI:10.4103/2249-4847.92237] [PMID] [PMCID]
17. Kokkonen M, Kalima T, Jääskeläinen J, Louhimo I. Duodenal atresia: late follow-up. J Pediatr Surg. 1988;23(3):216-20. [DOI:10.1016/S0022-3468(88)80725-5] [PMID]
18. Siersma CL, Rottier BL, Hulscher JB, Bouman K, van Stuijvenberg M. Jejunoileal atresia and cystic fibrosis: don't miss it. BMC Res Notes. 2012;5:677. [DOI:10.1186/1756-0500-5-677] [PMID] [PMCID]
19. Seo T, Ando H, Watanabe Y, Harada T, Ito F, Kaneko K, et al. Colonic atresia and Hirschsprung's disease: importance of histologic examination of the distal bowel. J Pediatr Surg. 2002;37(8):1-3. [DOI:10.1053/jpsu.2002.34495] [PMID]
20. Adams SD, Stanton MP. Malrotation and intestinal atresias. Early Hum Dev. 2014;90(12):921-5. [DOI:10.1016/j.earlhumdev.2014.09.017] [PMID]
21. Ludwig K, De Bartolo D, Salerno A, Ingravallo G, Cazzato G, Giacometti C, et al. Congenital anomalies of the tubular gastrointestinal tract. Pathologica. 2022;114(1):40. [DOI:10.32074/1591-951X-553] [PMID] [PMCID]
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2025 CC BY-NC 4.0 | Journal of Advances in Medical and Biomedical Research

Designed & Developed by : Yektaweb