The etiologic role of intrauterine volvulus and intussusception in jejunoileal atresia

Although intussusception has been reported as quite a rare cause of jejunoileal atresia (JIA), pediatric surgeons have noted the frequent presence of intussusception as well as volvulus at surgery. The aim of this study was to investigate the contribution of intrauterine intussusception and volvulus...

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Bibliographic Details
Published in:Journal of pediatric surgery 2004-12, Vol.39 (12), p.1812-1814
Main Authors: Komuro, Hiroaki, Hori, Tetsuo, Amagai, Teruyoshi, Hirai, Misako, Yotsumoto, Katsumi, Urita, Yasuhisa, Gotoh, Chikashi, Kaneko, Michio
Format: Article
Language:English
Subjects:
Female
Fetal Diseases
Humans
Ileal Diseases - complications
Ileum - abnormalities
Infant, Newborn
Intestinal Atresia - etiology
Intestinal Volvulus - complications
intrauterine
intussusception
Intussusception - complications
Jejunal Diseases - complications
Jejunoileal atresia
Jejunum - abnormalities
Male
vascular disruption
volvulus
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Summary:Although intussusception has been reported as quite a rare cause of jejunoileal atresia (JIA), pediatric surgeons have noted the frequent presence of intussusception as well as volvulus at surgery. The aim of this study was to investigate the contribution of intrauterine intussusception and volvulus to the development of JIA. In 48 newborns (24 boys and 24 girls) treated for JIA at our hospital between 1978 and 2004, the operative and pathologic findings were reviewed. Intussusception was responsible for gap and cord type atresia in 12 cases (25%). The cord showed an atrophic intestinal lumen in 2 cases. Volvulus was observed in 13 cases. Volvulus and intussusception were simultaneously noted in 1 case. This suggested that intussusception was the cause of the atresia, whereas volvulus was a secondary event. Neither intussusception nor volvulus was observed in high jejunal, apple peel, or multiple atresia. Intrauterine volvulus and intussusception were commonly observed in single mid- and low JIA. Thus, intrauterine intussusception may be a common cause of gap and cord type JIA. Volvulus may not only cause JIA but also result from anatomic changes after the development of JIA in some cases.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2004.08.037