A.A.

Made Wijaya Kusuma1, Made Kardana1, Deddy Ariyanta2

1 2
Departments of Child Health and Pediatric Surgery ,
Udayana University Medical School, Sanglah Hospital, Denpasar

Background

Jejunoileal atresia is one of the major cause of neonatal intestinal obstruction that requires
surgical intervention in the neonatal period. Incidence of jejunoileal atresia estimated about 1 of
3,000 live birth. Most affected newborn infants present with bilious vomiting and abdominal
distention. There hasnt been any reports of combination of jejunal atresia and ileal agenesis in
neonates until now.

Objective

To report a rare case about a combination of type I jejunal atresia and ileal agenesis in neonate.

Case
Twelve-hour old full term male neonate,
weighted 2.85 kg, presented with complaint
of nine episodes of bilious vomiting in the
last six hour. Physical examination showed
bloated abdomen without any other
anomaly. The result of X-ray examination
showed distension of abdominal cavity with
triple bubble sign.
Conclusion
This combination of type I jejunal atresia
and ileal agenesis is the first case reported.
Although the surgery has been performed,
this case has a poor prognosis as a result of
ultra-short bowel syndrome.

Laparotomy-exploration was done at the

age of 4 days to confirm the diagnosis.
During exploration, an undeveloped distal
part of jejunal atresia was found and only
small portion of sigmoid and rectum were A B
seen. The patient then diagnosed as type I
jejunal atresia and ileal agenesis. End to
end anastomose between jejuno-
colonostomy was performed.

The patient was treated in the NICU with

antibiotics, total parenteral nutrition, and
phototherapy for hyperbilirubinemia. Patient
started to have continuous enteral feeding C D
after 4 days post operative. After 40 days
post-operative care, patient passed away Fig A. Abdominal distention; Fig B. Triple bubble
with cause of death were sepsis and ultra- sign on X-ray examination; Fig C and D. Jejunal
short bowel syndrome.
atresia with undeveloped ileal