PMC9989415_01
(a, b) Ultrasound image at the 19th week of gestation, showing extra-abdominal bowel loops.
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Moderate polyhydramnios was present (Figure 1(a) and (b)).
(a) Ultrasound image at the 32nd week of gestation, showing no prolapsed bowel and dilated residual intra-abdominal loop and (b) abdominal X-ray at birth.
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At the 32nd week of gestation, a cesarean section was performed because of ascitic effusion and distension of the remaining intra-abdominal loops (Figure 2(a)). An abdominal plain X-ray revealed distension of cranially located small intestinal loops, which was compatible with atresia of the small intestine (Figure 2(b)).
(a) Aspect of the bowel at laparotomy and (b) schematic drawing of the anomaly.. S: Stomach; D: Duodenum; T: Treitz; J: Jejunum; C: Colon; R: Rectum.
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Laparotomy was performed through which a type 3A jejunal atresia was diagnosed along with extensive midgut atresia (Figure 3(a)). The measured length of the small intestine was about 13 cm, while the colonic segment was about 22 cm in length (Figure 3(b)).
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Contrast study showing proximal intestinal dilation (6 cm vs 1.5 cm of the distal bowel).
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TPN. The dilated jejunal segment (4x, evaluated by a contrast study:Figure 4) was divided to form two separate intestinal tracts, which were tubulized and anastomosed with each other in an isoperistaltic manner.
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