Adv Pediatr Surg.  2023 Jun;29(1):40-44. 10.13029/aps.2023.29.1.40.

Ileal Duplication in a Neonate With Jejuno-Ileal Atresia, Midgut Malrotation and Volvulus

• Dudhani S
• Suman B
• Singh R
• Sinha AK
• Kumar B

• KMID: 2551511
• DOI: http://doi.org/10.13029/aps.2023.29.1.40

Abstract

Jejuno-ileal atresia is often associated with various other gut pathologies. A 5-day male presented with bilious vomiting, abdominal distension and non-passage of stools. Exploratory Laparotomy showed a type IIIA ileal atresia with midgut volvulus and atypical malrotation for which Ladd’s Procedure and anastomosis of atretic bowel was done. A fleshy tubular structure extracted from distal bowel showed ileal duplication. In JIA, the vascular theory of pathogenesis is widely accepted with multiple studies to suggest the same. The mechanism being mesenteric ischemia leading to intestinal necrosis, resorption, and atresia. It has been found that abdominal duplication cyst often occurs simultaneously with short bowel, intestinal atresia, stenosis and enteric duplication for which a common vascular pathogenetic mechanism has been suggested. Our case serves as an in vivo description of the proposed theory where the findings may be described elegantly. We describe and discuss the mesenteric ischemia theory in bowel atresia and hope to further our understanding about the same.

Keyword

Intestinal atresia; Volvulus of midgut; Intestinal volvulus; Infant, newborn; Mesenteric vascular occlusion; Intussusception