Jejunal atresia, prenatally detected in a fetus and postnatal management: A case report

Abstract

A 24-year-old pregnant (gravida 1, para 0) applied to our antenatal out-patient clinic at 34th weeks of gestation without any follow-up before. Ultrasonographic screening revealed presence of hypoechoic multiloculated cystic dilatations in the fetal abdomen and slight polyhydramnios, suggesting jejunal atresia. A male baby weighing 2850g was delivered by spontaneous vaginal route at 37th weeks of gestation. There was abdominal distention in physical examination of the baby. Direct abdominal graphy demonstrated proximal dilated loops of intestines as well as a normally rotated colon, confirming the diagnosis of small bowel obstruction. Urgent laparotomy was performed. During the operation, dilated intestinal loops and also atresic segment of bowel 50 cm distant from Treitz with mesenteric defect was according to "type 3a" jejunal atresia deformity. An end-to-end anastomosis was done after resection of both the proximal and distal small bowels. Partial parenteral nutrition and antibiotic therapy were administered postoperatively. On 21st day of postoperative period, exitus has occurred depending on sepsis. Chromosomal analysis was normal (46, XY). Prenatal diagnosis of small bowel obstructions is quite important for postnatal management and prognosis of the affected babies.