High Jejunal Atresia: Clinical Characteristics and Treatment

Abstract

Purpose: High jejunal atresia occurring near the ligament of Treitz is rare. It is a complicated type of small bowel atresia, and its treatment is challenging. Our study describes the clinical characteristics and proper management of high jejunal atresia.

Methods: We performed a retrospective review of seven neonates who underwent operations for high jejunal atresia between January 2000 and April 2021.

Results: The sex ratio showed a male predominance, and all patients were prenatally diagnosed with small bowel atresia. Six patients presented with a typical triple bubble appearance on the preoperative abdominal film. The location of the atresias were around the ligament of Treitz or less than 10 cm from the ligament of Treitz, and the types of atresia comprised three cases of type I, two of type IIIb, and two of type IV. Five of the seven patients underwent the operation without proximal enteroplasty. The median duration from operation to full feeding was 23 days, with three patients requiring more than a month to reach full feeding. There were no other operation-related complications. At the long-term follow-up, all patients tolerated oral feeding well.

Conclusion: This study indicates that high jejunal atresia close to the ligament of Treitz exhibits a high incidence of type I and complex types of atresia, and that primary anastomosis, without proximal enteroplasty, can be applied through surgical intervention