Jejunal web as the cause of bowel obstruction in an infant: case report and brief literature review

婴儿空肠隔膜引起肠梗阻:病例报告及文献简述

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Abstract

INTRODUCTION: Jejunoileal atresia is a rare congenital anomaly causing intestinal obstruction in neonates, with increased complexity in premature infants. This rare condition presents diagnostic and management challenges, particularly in preterm populations. PRESENTATION OF CASE: This case report describes a 28-week gestational age female infant diagnosed with Type I jejunal atresia. The patient exhibited classic symptoms of intestinal obstruction: abdominal distension, bilious vomiting, and failure to pass meconium. Radiographic findings suggested intestinal obstruction, prompting an exploratory laparotomy. Intraoperatively, Type I jejunal atresia was discovered 5 cm distal to the duodenojejunal flexure. Surgical intervention involved excision of the intraluminal web and transverse closure of the bowel. The postoperative course was complicated by prolonged ileus, which resolved by day 6. DISCUSSION: This case highlights the challenges in diagnosing and managing JIA in extremely preterm infants. Preterm status can hinder timely diagnosis, as demonstrated by previous reports of JIA diagnoses in preterm infants occurring beyond 30 days of age. The presentation of JIA in preterm infants may be atypical or masked by other complications of prematurity, necessitating a high index of suspicion among clinicians. The successful management of this case aligns with current literature suggesting that planned surgical intervention prior to the development of sepsis or bowel perforation is associated with better outcomes. The prevalence of prematurity in JIA cases is significant, with one study reporting that 87.0% of children with abdominal wall defects associated with JIA were premature. CONCLUSION: Prompt diagnosis of JIA and surgical intervention can lead to successful outcomes.

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