Background: In the study, we evaluated efficacy and complications of T-tube application in treatment of intestinal atresia in newborns. Methods: In this randomized clinical trial study, 40 neonates with intestinal atresia were studied. The patients were divided into two comparable groups. After preparation of general conditions for operation, the surgery was applied under general anesthesia. In the first group, primary end-to-end anastomosis with T-tube application and in the second group only primary end-to-end anastomosis was done. Baseline variables (age, sex and birth weight), signs of disease, interval between surgery and beginning of oral nutrition, duration of hospitalization, post operation complications and mortality were compared between the two groups.Results: Age, sex, birth weight, age in operation time, frequency of abdominal distention, bilious vomiting, failure of meconium pass and congenital anomalies were not different significantly. Also interval between surgery and beginning of oral nutrition was not different. In 2 of 20 neonates (10%) in T-tube group post operation complications occurred, but in the other group, 9 neonates of 14 neonates (64.3%) complications were seen after operation (p=0.002). Two neonates (10%) in T-tube group and 8 neonates (40%) in the other group died during post operation follow up (p=0.03). Conclusion: It seems that primary end-to-end anastomosis with T-tube application in neonates with intestinal obstruction decreased complications and mortality rate. More similar studies with larger samples are recommended.

Background and Objective: Intestinal atresia is a life-threatening problem requiring early active intervention. The aim of the study was to compare management outcomes between Duodenal-Atresia (DA) and Jejunoileal-Atresias (JIA). Methods: Retrospective descriptive analysis of patients operated between March 2015 to February 2020 in a tertiary-care Pediatric Surgery unit of Armed Forces Medical College Pune, India. The data was obtained from the hospital records, operation theatre notes, discharge summary and follow-up notes. Demographic and clinical information and data were analyzed with SPSS version 26 with appropriate statistical tools. Findings: Forty-eight neonates were included (DA=23,JIA=25). There were 18 (37. 5%) males and 30 (62. 5%) females. The mean age, mean birth weight, and time to feed were statistically significant and better in JIA compared to DA. A total of 45% of newborns had associated anomalies. The primary surgery performed in patients with DA was Kimura's duodenoduodenostomy, while Resection-anastomosis with or without tapering enteroplasty was performed in JIA patients. In the subgroup analysis of JIA, the length of hospital stay in the tapering enteroplasty was statistically significant compared to resection anastomosis. (p=0. 048). The average weight gain and survival in Jejunoileal-atresia at six months is statistically significant compared to Duodenal-atresia. Conclusion: The management of intestinal atresias is challenging and requires a dedicated team in a specialized neonatal intensive-care unit. Intensive investigation of other congenital anomalies associated with the condition is equally critical and in the subgroup analysis of JejunoIlial-atresia, the patients undergoing tapering enterostomy showed better survival compared to resection and end to end anastomosis only.

Intrauterine intussusception is a rare cause of intestinal atresia. Intrauterine intussusception was identified as etiological factor in only 0.6% of the cases. The pathophysiology of this correlation remains unclear. Antenatal intussusception leads to a partial intestinal necrosis and intestinal atresia in the concerned digestive segment. Here we report a case of ileal atresia consequent to intrauterine intussusception. A full-term neonate presented with features of neonatal intestinal obstruction. Antenatal ultrasound was normal. Screening neonatal examination at birth was normal. At presentation, vital signs were normal, abdomen was distended with bilious residue in the nasogastric tube. Abdominal radiography showed dilated small intestine with multiple air-fluid levels. Pre-operative Ultrasound scan showed intussusception with dilated bowel loops. At surgical exploration the neonate had ileal atresia with ileo-ileal intussusception, just distal to the atretic ileal segment. The neonate was managed successfully by resection and end to back anastomosis. The authors conclude that intrauterine intussusception is one of the rare causes of intestinal atresia and if an antenatal scan shows any target sign without any bowel dilatation, the baby should be delivered at a tertiary care center having neonatal intensive care facility, as it might lead to ischemia and atresia of the involved bowel.

Atresia of the colon is a rare anomaly with an incidence of between 1: 20, 000 and 1: 66, 000 live births being reported. Hirschsprung’s disease association with Colonic atresia is usually diagnosed after several failures of intestinal anastomoses. We herein report one of the first patients in the literature diagnosed before a therapeutic challenge. A 2-day-old female was admitted with severe abdominal distention, bilious vomiting and failure to pass meconium. A distended abdomen accompanied by hypoactive bowel sounds was also observed. Abdominal X-ray revealed increased intestinal gas, mainly in the colon. Type IIIa atresia of the colon at the level of the splenic flexure was found at laparotomy. A temporary double-barrel colostomy was completed, and she was discharged from hospital on the tenth day after operation without any complications. At the age of 3 months, due to the aspect of the distal colon, a rectal biopsy was performed and aganglionosis was confirmed. The combination of intestinal aganglionosis and colonic atresia is extremely rare. The concomitance of colonic atresia and aganglionosis is calculated to be in 1 in 10 million live births. Wilson, et al. claims that 80 percent of infants with colonic atresia have associated gastrointestinal anomalies. These defects include rotation and fixation anomalies. However, aganglionosis and intestinal neuronal dysplasia should be taken into account as well. When both diseases are combined, the etiology is still uncertain and several etiologies have been suggested. The association should be suspected in all cases of colonic atresia and rectal biopsies are advocated at the primary operation in patients with atresia of the colon.

Background: Jejuno-ileal atresia (JIA) is a congenital anomaly characterized clinically by bilious vomiting and abdominal distension. The incidence of JIA is between 1: 330 to 1: 3000 live births in different parts of the world. It has been associated with various congenital anomalies but the association of JIA with biliary atresia is extremely rare (0-3.2 %).Case Presentation: We herein present a case of jejunal atresia with meconium peritonitis associated with biliary atresia. The patient was a boy who was born at 39 weeks of gestation with polyhydramnious detected on Prenatal Ultra Sonography done at 8thmonth of gestation. Conclusion: It is important to explore gallbladder in cases of JIA especially when associated with meconium peritonitis.