What is Small Bowel Atresia?

Small bowel atresia (also called intestinal atresia) is a birth abnormality that affects the small intestine. The small intestine is the tube that connects the stomach to the large intestine and helps the body break down food.

Depending on the severity of the blockage, the problem is called either atresia or stenosis:

• Atresia: A total blockage or a gap in the bowel where the tube is not continuous.
• Stenosis: A partial blockage where the gut is very narrow, making it difficult for food to pass.

What are the different types of blockages?

Small bowel atresia is named after the specific part of the digestive path where the blockage occurs. The small intestine has three main parts: the duodenum, the jejunum, and the ileum.

Pyloric Atresia

This is the rarest type. It happens at the pylorus, which is the opening that connects the stomach to the beginning of the small intestine. It occurs in about one in every million babies. If this area is blocked, the stomach ends in a "blind" wall and cannot send food to the intestines.

Duodenal Atresia

This is the most common type found before birth. It occurs in the duodenum (the first part of the small intestine). About 1 in every 6,000 to 10,000 babies are born with this condition.

Jejunoileal Atresia

This is the most common intestinal blockage found in newborns overall. For every one case of duodenal atresia, there are usually two cases of this type. It can be divided into two categories:

• Jejunal Atresia: A blockage in the middle part of the small intestine (the jejunum).
• Ileal Atresia: A blockage in the lower part of the small intestine (the ileum) before it meets the colon.

How is it diagnosed before birth?

Doctors usually find small bowel atresia before a baby is born using a prenatal ultrasound or a fetal MRI. It is rarely seen before 18 weeks of pregnancy and can still be hard to see at 24 weeks. Most cases are diagnosed in the third trimester.

Signs Found on Ultrasound

• Dilated Bowel: Because of the blockage, fluid cannot pass through. This causes the intestine to swell and look much larger than normal on the ultrasound.
• The "Double Bubble" Sign: This is a classic sign of duodenal atresia. It shows fluid in the stomach and the first part of the intestine, but nowhere else.
• Polyhydramnios: This is an increase in the fluid surrounding the baby (amniotic fluid). Normally, a baby swallows this fluid, it passes through the gut, and the baby pees it out. If the gut is blocked, the baby cannot process the fluid, causing it to build up in the mother's uterus.

Risks for the Mother

Extra fluid (Polyhydramnios) can make the mother very uncomfortable and increases the risk of the baby being born early because the uterus is stretched.

Are other health conditions linked to this?

Because there is a higher risk of other birth abnormalities, a doctor will recommend a full prenatal exam. This condition is sometimes linked to:

• Cystic fibrosis
• Trisomy 21 (Down syndrome)
• Heart disease
• Bowel rotational problems
• Esophageal atresia (blockage in the food pipe)

How is it diagnosed after birth?

If it wasn't caught during pregnancy, a doctor will look for signs in the newborn, such as frequent vomiting. Tests used after birth include:

• Abdominal X-rays: To see the layout of the baby's belly.
• Contrast Studies: A special liquid is used to show exactly where the blockage is.
• Echocardiogram: An ultrasound of the heart to check for any heart problems.

What is the treatment?

Currently, there is no way to fix this before the baby is born. The focus is on careful monitoring during pregnancy so the doctor can provide specialized care immediately after birth.

Giving Birth

Babies with this diagnosis should be born in a specialized hospital that has pediatric surgeons and newborn experts ready. It is better for the baby to be born at the right hospital than to be transported after birth, as travel can be stressful and cause fluid loss.

What happens right after the baby is born?

A team of doctors, including surgeons and newborn specialists, will work to stabilize the baby. During this time:

1. NG Tube: A tube is placed through the nose into the stomach to keep it empty and prevent pressure.
2. IV Lines: These are placed in the baby's umbilical cord or veins to provide fluids and nutrition since the baby cannot eat.
3. Testing: The doctor will perform blood tests and more imaging (X-rays) to confirm the exact location of the blockage.

How is the surgery performed?

Once the baby is stable, the doctor will perform surgery to remove the blockage and connect the healthy parts of the intestine together. This is usually done in a specialized intensive care unit to minimize the risk of moving the baby.

What to expect after surgery?

The baby will stay in the hospital until they can eat enough to gain weight. Two weeks after leaving the hospital, you must see the surgeon for a follow-up appointment.

Feeding and Breast Milk

The baby will start eating very slowly. If breast milk is available, it is the best option. It will be given through a feeding tube at first. As the baby gets stronger, they will transition to eating by mouth. The doctor may suggest "non-nutritive sucking" (using a pacifier or an empty breast) to help the baby practice sucking while they recover. This process can take days or even weeks.

When should you call a doctor?

You should call your child's doctor immediately if:

• The child has a fever over 101°F.
• The child has fewer wet diapers than usual.
• The child is vomiting and refusing to eat.
• The surgery site looks red, swollen, or starts to leak fluid.

What is the long-term outlook?

The long-term results for babies born with this condition are excellent. Survival rates have increased to 90% over the last 50 years. Most children go on to live healthy lives.

However, some children may face future challenges with digestion or nutrient absorption. They may need to see a nutritionist to monitor their growth. In some cases, a child might go home with a temporary feeding tube to ensure they get enough nutrition while their body continues to heal. Long-term support programs involving a team of doctors, dietitians, and social workers are available to help families manage these needs as the child grows.

Why choose Tender Palm Super-Speciality Hospital for Small bowel atresia (Intestinal atresia) treatment for children in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Small bowel atresia (Intestinal atresia) treatment for children in Lucknow, India, at an affordable cost. We have a team of experienced pediatric surgeons and neonatal specialists who provide accurate diagnosis with advanced imaging, personalized medical care, and precise surgical treatment tailored to each infant's specific condition. Our Pediatric Surgery team has decades of experience in successfully treating Small bowel atresia (Intestinal atresia) in Lucknow, India.

To seek an Expert Consultation for Small bowel atresia (Intestinal atresia) treatment for children in Lucknow, India:

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Email at care@tenderpalm.com

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