Abstract
Neonatal ileal atresia is a form of intestinal obstruction characterized by narrowing, complete closure, or absence of a segment of the ileum. This case involves a 5-day-old female neonate presented with abdominal distension and bilious vomiting. The neonate, delivered via spontaneous vertex birth weighing 2.9 kg, showed no fever and maintained stable vital signs during examination. Physical assessment revealed abdominal distension, hyper-tympanic areas, dullness in the lower quadrants, reduced bowel sounds, and a patent anus with an empty rectum. Imaging studies confirmed intestinal obstruction from dilated small bowels, leading to explorative laparotomy identifying ileal atresia, necessitating cecostomy placement. Despite surgical intervention, the neonate experienced nutritional complications and unfortunately passed away three days postoperatively. This case underscores the complexities of early diagnosis and management in neonates with intrauterine conditions, particularly in resource-limited settings with limited access to total parenteral nutrition.