Summary about Disease
Jejunal atresia is a birth defect where the jejunum (the middle section of the small intestine) is blocked or absent. This blockage prevents the normal passage of digested food through the digestive system. It's a type of intestinal atresia, and its severity can vary depending on the extent and location of the blockage. It requires surgical intervention soon after birth to correct the abnormality.
Symptoms
Abdominal distension (swelling)
Vomiting (often green or yellow bile-stained)
Failure to pass meconium (the first stool of a newborn) within the first 24-48 hours
Poor feeding
Dehydration
Causes
The exact cause is not always known, but jejunal atresia is generally thought to arise from a vascular accident (disruption of blood supply) in the womb during fetal development. This vascular disruption leads to intestinal ischemia (lack of blood flow), which can cause the intestine to narrow, become completely blocked, or be absorbed (in cases of complete atresia). Genetic factors are also suspected to play a role in some cases.
Medicine Used
Jejunal atresia requires surgical correction and the use of medicines play a supportive role.
Antibiotics: Broad-spectrum antibiotics are administered to prevent infection before and after surgery.
Pain Medication: Post-operative pain management is usually accomplished with analgesics, such as opioids (e.g., morphine) or non-opioid pain relievers (e.g., acetaminophen).
Intravenous Fluids (IV Fluids): Fluids with electrolytes and possibly glucose are crucial to prevent dehydration, address electrolyte imbalances, and provide nutrition prior to the infant tolerating enteral feeding.
Total Parenteral Nutrition (TPN): As enteral feeding are interrupted due to atresia condition, parenteral nutrition is needed, usually until the intestines can function normally after the operation.
Is Communicable
No, jejunal atresia is not communicable. It is a congenital birth defect, not an infectious disease.
Precautions
Jejunal atresia is not preventable since it is a congenital birth defect.
How long does an outbreak last?
Since jejunal atresia is not an infectious disease, it does not involve outbreaks. This condition is present at birth.
How is it diagnosed?
Prenatal Ultrasound: Sometimes, jejunal atresia can be suspected during prenatal ultrasound scans if dilated bowel loops are observed in the fetus.
Abdominal X-ray: After birth, an abdominal X-ray will typically show dilated loops of bowel proximal to the atresia, with little or no air in the distal bowel.
Contrast Enema: In some cases, a contrast enema may be used to visualize the lower bowel and confirm the presence of a blockage.
Clinical Presentation: The combination of abdominal distension, vomiting, and failure to pass meconium raises suspicion for intestinal obstruction, prompting further investigation.
Timeline of Symptoms
Symptoms typically appear very soon after birth, usually within the first 24-48 hours:
0-24 hours: Failure to pass meconium.
0-48 hours: Abdominal distension develops. Vomiting usually starts during this period. The vomiting may be bile-stained.
Ongoing: If untreated, dehydration and electrolyte imbalances will worsen.
Important Considerations
Early Diagnosis and Treatment: Early diagnosis and surgical intervention are crucial for improving the outcome and survival of infants with jejunal atresia.
Nutritional Support: Postoperative nutritional support, often with TPN, is essential until the infant can tolerate enteral feedings.
Potential Complications: Potential complications include short bowel syndrome (if a large portion of the intestine needs to be removed), adhesions, and feeding difficulties.
Multidisciplinary Care: Management requires a multidisciplinary team, including neonatologists, pediatric surgeons, nurses, and dietitians.