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. 2022 Jan;64(1):e15208.
doi: 10.1111/ped.15208.

Incidence of late severe intestinal complications after bowel atresia/stenosis

Takahiro Hosokawa  1 , Yutaka Tanami  1 , Yumiko Sato  1 , Tetsuya Ishimaru  2 , Hiroshi Kawashima  2 , Eiji Oguma  1
Affiliations

Incidence of late severe intestinal complications after bowel atresia/stenosis

Takahiro Hosokawa et al. Pediatr Int. 2022 Jan.

Abstract

Background: To determine the incidence and risk factors for late severe intestinal complications after surgical repair for intra-abdominal congenital intestinal atresia/stenosis.

Methods: We included 51 patients who underwent surgical repair for congenital intestinal atresia/stenosis. Late severe intestinal complications included adhesive ileus, incisional hernia, or volvulus. Whether surgical intervention was urgent or not was recorded. The location of the atresia/stenosis was classified into two groups: atresia/stenosis located at the oral or anal side from the Treitz ligament. The type of atresia/stenosis was classified as low-risk types (type I, mucosal web/II, fibrous cord/IIIa, mesenteric gap defect) and high-risk types (IIIb, apple peel/IV, multiple atresia). We compared the incidence of late intestinal complications between the location of intestinal atresia/stenosis at the oral and anal side of Treitz ligament, and between low- and high-risk types of atresia/stenosis using Fisher's exact test.

Results: Eight (15.7%) had late intestinal complications, all of which occurred in patients with intestinal atresia/stenosis located on the anal side of the ligament of Treitz. Urgent surgical intervention was needed in four cases. There was a significant difference in the location of atresia/stenosis (with vs. without late intestinal complications at oral/anal side of the Treitz ligament: 0/8 vs. 24/19; P = 0.005) and the type of intestinal atresia/stenosis (with vs. without that accompanying low-/high-risk type: 5/3 vs. 41/2; P = 0.023).

Conclusions: Physicians should consider the presence of intestinal complications that require surgical intervention in patients undergoing surgical reconstruction for jejunal and ileal atresia/stenosis with abdominal symptoms.

Keywords: Treitz ligament; complication; congenital intestinal obstruction; duodenal atresia; small bowel atresia.

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