Jejunal Atresia With a Rare Association: A Case Report and Literature Review

TL;DR

A rare case of a neonate with both jejunoileal and rectal atresia is reported, highlighting the need for thorough evaluation to avoid misdiagnosis and multiple surgeries.

Contribution

This case report documents a previously unreported combination of jejunoileal and rectal atresia in a neonate.

Findings

The neonate had type 4 jejunoileal atresia and proximal rectal atresia, an exceedingly rare combination.

Postoperative complications led to the discovery of rectal atresia, requiring additional surgery.

Thorough evaluation of the lower gastrointestinal tract is crucial to prevent misdiagnosis and reduce surgical interventions.

Abstract

Jejunoileal atresia, a common cause of neonatal intestinal obstruction, typically manifests shortly after birth. This case report highlights a rare instance of a late preterm female neonate presenting with type 4 jejunoileal atresia along with proximal rectal atresia, an exceedingly uncommon combination. Initial symptoms included bilious emesis and failure to pass meconium, leading to surgical correction of jejunoileal atresia. However, postoperative complications, including vomiting and jaundice, prompted further investigation, revealing rectal atresia during a fluoroscopic study on day 29. Subsequent surgery was required to address the rectal atresia, resulting in additional challenges such as short bowel syndrome and infection. The complexity of diagnosis and management underscores the importance of thorough evaluation of the lower gastrointestinal tract in neonates with jejunoileal atresia to prevent misdiagnosis and reduce the need for multiple surgeries. Rectal atresia, which is a very rare anorectal abnormality, in combination with jejunoileal atresia is considered an incredibly unusual, exceptionally unique case; as to our knowledge, no similar presentation had previously occurred. Prompt identification and simultaneous treatment of both conditions can help mitigate complications, minimize the risk of necrosis and perforation, and improve overall outcomes. Comprehensive management strategies that encompass thorough diagnostic evaluation and coordinated surgical interventions are crucial for optimizing the care of neonates with complex intestinal malformations, ensuring timely resolution of symptoms, and reducing long-term morbidity.

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