What are the classes of neonatal intestinal atresias?

neonatal intestinal atresias

One of the intestinal birth defects, seen often in children is intestinal atresia. Intestinal atresia, diagnosed by the Best Pediatrician in Lahore results in intestinal obstruction, and is a surgical emergency. Read on to know more about intestinal atresia, its classes and symptoms:

What is intestinal atresia?

Intestinal atresia is a broad term, encompassing both stenosis—partial obstruction, and atresia—complete blockage. During evaluation, it is classified based on its location along with the gut. In comparison to large intestine, small bowel atresia is more common.

This condition is often congenital, which means it forms during gestation and presents before birth. The exact cause is not understood; however, it is postulated that a vascular accident or use of certain medication, impeding the blood supply of the intestines results in this malformation.

Intestinal atresia can be diagnosed right after birth, and even during pregnancy. Before birth, routine ultrasonography can show that the baby has distended gut, if there is stenosis alone, or there can be polyhydramnios or excessive amniotic fluid in the gestational sac in case of complete blockage.

If there is complete atresia of the intestine, the baby is unable to swallow the amniotic fluid, resulting in polyhydramnios. The classes of intestinal atresia detectable prenatally include: type II, III and IV; only intestinal stenosis and type I atresia can be difficult to diagnose before birth.

Babies with type III and IV atresia have higher risk of preterm labor, and are more likely to have shorter gut. Healthcare providers can use detailed ultrasonography techniques and even fetal MRIs to gather more information about intestinal atresia before birth.

What are the symptoms of intestinal atresia?

The signs and symptoms of intestinal atresia include:

  • Low birth weight
  • Premature birth
  • Polyhydramnios
  • Jaundice
  • Failure to pass stool in the first 24 hours after birth
  • Bilious vomiting
  • Distended abdomen
  • Electrolyte disturbances
  • This is followed by signs of dehydration like:
    • Dry skin and mucous membranes
    • Sunken eyes and fontanel
    • Decreased pulse pressure
    • Rapid heart rate
    • Low grade fever
    • Decreased urine output
    • Lethargy, inability to feed, irritability and even coma

What are the classes of intestinal atresia?

Intestinal atresia is divided into classes, based on the extent of blockage. This classification includes:

  • Stenosis: this refers to incomplete or partial blockage, and resembles type I atresia. In this type, the mesentery of the small bowel is intact and the length of the gut is normal.
  • Type I atresia: in this type, the blockage is caused by web-like membranes inside the intestine, which form during gestation. The bowel walls and mesentery are intact, and the length of the gut is normal.
  • Type II atresia: in this type, one or more segments of intestine are involved, with segments forming “blind ends”. These blind ends are connected by fibrous tissue. As with type I, the mesentery is intact and the length of the intestine is normal.
  • Type III atresia: this is the most common type of intestinal atresia. The length of the gut is shortened, most likely due to vascular insult.
    • Type III-a: in this subtype, there are two blind ends, completely separated from each other. Unlike type II, there is no fibrous tissue connecting these blind ends. There is also a v-shaped mesenteric gap in between, with a possibility of the intestine undergoing torsion.
    • Type III-b: this type of intestinal atresia is also called apple-peel or Christmas-tree deformity. There is formation of two blind ends, with large mesenteric defects in between. The superior mesenteric artery (SMA) is absent in this defect. Patients with this type are often born prematurely, and has other intestinal defects like malrotation.
  • Type IV atresia: this type is a combination of type I, II and III of atresia and gives the intestine a ‘string-of-sausage’ appearance. Babies born with this type of intestinal atresia have a significantly shorter gut. Any kind of atresia needs proper workup and investigation for diagnosis, as offered by a child specialist in Maroof International Hospital.
By bella

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