Type IV jejunal atresia in a newborn: a rare birth defect presenting with bilious vomiting

ABSTRACT

Background: Type IV jejunal atresia is a rare birth defect, which occurs due to late intrauterine vascular accidents that results in complete obstruction of intestinal lumen. There is no genetic predilection. It occurs most commonly in proximal jejunum. Clinical presentation includes bilious vomiting, abdominal distension, feeding difficulties, failure to pass stools and/or absence of bowel movements after birth. Here author report a case of premature newborn, who was admitted in NICU at birth in view of prematurity. As the baby had bilious vomiting and bilious NG aspirate on day 3 of life, possibility of intestinal obstruction was kept. It was diagnosed as a case of jejunal atresia by abdominal radiograph displaying dilated stomach, duodenum and proximal jejunum with gasless abdomen. Further jejunal atresia confirmed by the upper GI study exhibiting the level of obstruction. Surgical resection of the atretic segment and primary anastomosis was done. This case emphasizes the need of rapid identification of jejunal atresia and its adequate management to prevent morbidity and mortality associated with fore shortened intestine.