ileal atresia

Newborn with
failure to pass meconiumEnema shows a microcolon with an inability to reflux contrast into the dilated loops of distal small bowel.The diagnosis was ileal atresia.
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Newborn with
failure to pass meconium. AXR supine (above left) and AXR left lateral decubitus (above right) show multiple dilated loops of bowel with no gas in the rectum. AP (below left) and lateral (below right) views of an enema show the colon to be small in diameter throughout its length (microcolon) and to contain filling defects representing pellets of meconium. The terminal ileum could not be refluxed despite multiple attempts to do so.The diagnosis was ileal atresia.
pediatricimaging.org • CC-by-nc-sa 4.0
Newborn who
is vomiting with feeds. AXR (left) shows multiple loops of dilated bowel suggesting a distal bowel obstruction. AP image from an enema (right) shows the colon to be small in caliber (a microcolon). Despite multiple attempts, the terminal ileum could not be refluxed with contrast.The diagnosis was ileal atresia.
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Ileal atresia is a congenital abnormality where there is significant stenosis or complete absence of a portion of the ileum. There is an increased incidence in those with chromosomal abnormalities.

This article will focus on ileal atresia alone but bear in mind that some cases correspond to jejunoileal atresia and show a mixed pattern, including the ones discussed in the jejunal atresia article.

Pathology

Ileal atresia results from a vascular accident in utero that leads to decreased intestinal perfusion and subsequent ischemia a segment of bowel. This leads to narrowing, or in the most severe cases, complete obliteration of the intestinal lumen.

Associations

Radiographic features

Plain radiograph

In the postnatal period, an abdominal radiograph will show air in the dilated loops of proximal bowel.

Fluoroscopy

Enema shows microcolon.

Antenatal ultrasound

An ileal atresia is often discovered prenatally at a routine prenatal ultrasound scan or following the development of polyhydramnios. On ultrasound, there is frequently a proximal dilated intestinal segment.

Treatment and prognosis

Surgical treatment depends on the severity of obstruction and length of the damaged bowel but is usually curative.

See also

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Ileumatresie:
Mekoniumileus
 
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Ösophagusatresie
 
Wikipedia • CC BY-SA 3.0
Analatresie
 
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zystische
Fibrose
Wikipedia • CC BY-SA 3.0
Duodenalatresie
 
Wikipedia • CC BY-SA 3.0
Morbus
Hirschsprung
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