Congenital Intestinal Atresia and Surgical Management

Congenital intestinal atresia encompasses a spectrum of developmental anomalies in which a segment of the gastrointestinal tract fails to canalise, resulting in obstruction. The condition may affect any portion of the small or large bowel, with duodenal, jejunoileal and colonic forms differing in incidence and associated anomalies. Prenatal suspicion often arises through detection of polyhydramnios or dilated bowel loops on ultrasound, and postnatal presentation typically involves bilious vomiting, abdominal distension and failure to pass meconium. Underlying aetiologies include in utero vascular accidents, genetic syndromes and mechanical causes such as volvulus. Definitive management is surgical, ranging from primary resection with end-to-end anastomosis to staged procedures with proximal stoma formation when the distal calibre is severely compromised. Advances in minimally invasive techniques have enabled laparoscopic repair in selected centres, offering improved cosmesis and shorter recovery, although operative times may be longer in early series. Postoperative nutritional support—striking a balance between early enteral feeding via transanastomotic tubes and parenteral nutrition—has become a central focus in reducing catheter-related complications and enhancing intestinal adaptation. Long-term outcomes depend on presence of short bowel, associated cardiac or genetic anomalies, and quality of multidisciplinary follow-up to optimise growth and prevent adhesive obstruction.

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Congenital Intestinal Atresia and Surgical Management publication trend

The graph below shows the total number of articles in congenital intestinal atresia and surgical management across all publications each year (not limited to Nature Index journals).

Technical terms

Congenital intestinal atresia: A birth defect in which a segment of the intestine is absent or closed, causing obstruction.

Anastomosis: Surgical connection created between two ends of bowel after resection of an atretic segment.

Transanastomotic tube feeding: Placement of a feeding tube across the surgical join to enable early enteral nutrition.

Parenteral nutrition: Intravenous delivery of nutrients to bypass the gastrointestinal tract.

Polyhydramnios: Excessive amniotic fluid volume detected during pregnancy, often indicating fetal gastrointestinal obstruction.

References

1. The role of multimodal ultrasound in diagnosis of fetal bowel dilatation and prediction of adverse neonatal outcomes: A study of 86 cases in a series of 43,562 births. Heliyon (2024).
2. Congenital duodenal obstruction repair with and without transanastomotic tube feeding: a systematic review and meta-analysis. Archives of Disease in Childhood Fetal & Neonatal (2023).
3. Transition from Laparotomy to Laparoscopic Repair of Congenital Duodenal Obstruction in Neonates: Our Early Experience. Frontiers in Pediatrics (2017).
4. Jejunoileal Atresia: A National Cohort Study. Frontiers in Pediatrics (2021).