The Combination of Gastroschisis, Jejunal Atresia, and Colonic Atresia in a Newborn

Abstract

We encountered a rare case of gastroschisis associated with jejunal atresia and colonic atresia. In our case, the jejunal atresia was not discovered for 27 days after the initial abdominal wall closure. The colonic atresia was not discovered for 48 days after initial repair of the gastroschisis secondary to the rarity of the disorder. Both types of atresia were repaired with primary hand-sewn anastomoses. Other than the prolonged parenteral nutrition and hyperbilirubinemia, our patient did very well throughout his hospital course. Based on our case presentation, small bowel atresia and colonic atresia must be considered in patients who undergo abdominal wall closure for gastroschisis with prolonged symptoms suggestive of bowel obstruction. Our case report also demonstrates primary enteric anastomosis as a safe, well-tolerated surgical option for patients with types of intestinal atresia.

Figure 1

Upper gastrointestinal small bowel follow-through at 4 hours showing dilated loops of proximal small bowel and no progression of contrast through to the colon, suggestive of small bowel obstruction.

Figure 2

Barium enema showing microcolon and no progression of contrast proximal to the midtransverse colon suggestive of colonic obstruction.

Figure 3

Upper gastrointestinal small bowel follow-through showing no progression of contrast beyond the right side of the abdomen after 4 days suggestive of obstruction. Previous enteroenterostomy appears patent.