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Intestinal atresia and stenosis involve narrowing or closure of the intestine. Food is blocked from passing through the intestine, which prevents normal feeding and intestinal function. Intestinal atresia and stenosis usually involve the small intestine, but can affect any part of the gastrointestinal tract.
Intestinal stenosis is a partial obstruction that causes the center opening of the intestine to become narrower, while intestinal atresia is a complete closure of the intestine.
There are different types of intestinal atresia, depending on where the closure occurs.
The methods used to diagnose intestinal atresia and stenosis vary depending on the type (or location) of the obstruction in the intestine. In newborns with the symptoms listed above, an abdominal X-ray is usually all that is needed to establish a diagnosis, sometimes accompanied by an X-ray contrast enema. More and more, intestinal obstructions are detected with prenatal ultrasonography. Using this imaging technique, doctors may find excess amniotic fluid, a sign that the intestine can not properly absorb the fluid. If excess amniotic fluid is found on an ultrasound, infant will be examined for intestinal atresia and stenosis after his or her birth using these methods: lower GI series, upper GI series, and abdominal ultrasound.
Because many newborns with intestinal atresia also have other life-threatening problems, echocardiography and other imaging studies of the heart and kidneys may also be performed after the infant is stabilized.
Children with intestinal atresia and stenosis need surgery to correct the problem. The type of operation they require depends on where the obstruction is located. Before the operation, a tube is placed into the stomach (through the mouth) to remove the excess fluid and gas. This prevents vomiting and aspiration, as well as providing babies with some relief from the discomfort caused by a swollen abdomen. Nutrients are provided intravenously, to replace what was lost through vomiting.
Babies with intestinal atresia feed through a tube that goes through their nasal passages directly into the stomach. This is left in place until their bowel function returns, a period of time which may vary from a few days to several weeks. Once the intestines can function normally, nutrition is given orally or through a feeding tube passed into the small intestine. During the period of bowel inactivity, nutrition is provided intravenously.
After the surgery, parents can expect their child's hospital stay to last from one to several weeks, until the child's diet is enough to provide a good level of nutrition. However, the hospital stay is often longer for premature infants.
Children will require continued regular follow-up to make sure they are growing and developing normally, and to ensure that their intestine is absorbing enough of the nutrients they need.
If a baby has a sufficient length of intestine, and there are no other associated problems, he or she generally does well after recovery. Complications after surgical therapy are rare, but may occur. During immediate postoperative and early recovery period, intestinal contents may leak at the suture line. This can cause an infection in the abdominal cavity and require additional surgery. Possible long-term complications include short gut syndrome, malabsorption syndromes, and segments of intestine that cannot function properly because they are dilated or paralyzed.
Learn more about other Intestine Transplant Disease States.
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UPMC Children’s Hospital of Pittsburgh
One Children’s Hospital Way
4401 Penn Ave.
Pittsburgh, PA 15224
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