EN
TÜRKÇE
Poster - 99
An anatomical location of intestinal atresia as a predictor of clinical course in small bowel atresia: a two-center study at southern in Japan
Toshio Harumatsu 1, Yudai Tsuruno 2, Ayaka Nagano 2, Koshiro Sugita 2, Yumiko Tabata 1, Yumiko Iwamoto 2, Nanako Nishida 2, Chihiro Kedoin 2, Keisuke Yano 2, Shun Onishi 2, Hiroki Otsuka 3, Tomonori Kurimoto 3, Takafumi Kawano 2, Motofumi Torikai 1, Tokuhisa Takuya 3, Satoshi Ieiri 2
1 Department of Pediatric Surgery, Kagoshima City Hospital
2 Department of Pediatric Surgery, Kagoshima University
3 Department of Neonatology, Kagoshima City Hospital
Purpose: Small bowel atresia requires precise perinatal management and early surgical intervention owing to complications such as polyhydramnios and preterm labor. The etiology and pathology vary from case to case, and a prenatal diagnosis is possible in only approximately half of the cases. We investigated the relationship between the atretic location and both prenatal and operative findings to elucidate the characteristics of small-bowel atresia.
Method: We retrospectively reviewed the medical records of patients who underwent surgery for small-bowel atresia at two institutions between April 2000 and March 2024. Patients were divided into the jejunal atresia (JA) and ileal atresia (IA) groups, based on the atretic location relative to the ligament of Treitz. Cases of multiple atresia were classified according to the most proximal atretic site. We compared the prenatal and operative findings between the two groups.
Results: Fifty-eight patients were analyzed (JA group, n=22; IA group, n=36). The JA group showed significantly lower gestational age (33.4±3.3 vs 37.7±2.8 weeks, p<0.001) and birth weight (1970±671.6 vs 2893±644.2g, p<0.001) relative to the IA group. The JA group had higher rates of prenatal diagnosis (95.2% vs. 66.7%, p<0.05), polyhydramnios (92.9% vs. 20%, p<0.001), and bowel dilatation on prenatal ultrasound (95.0% vs. 67.9%, p<0.05). Additionally, cesarean delivery was significantly more frequent in the JA group than in the IA group (90.9% vs. 22.2%, p<0.001), and preterm delivery was more common (54.5% vs. 25.7%, p<0.05). There was a significant correlation between birth weight and the distance from the ligament of Treitz to the site of atresia (correlation coefficient=0.63, p<0.0001).
Conclusions: The clinical features of small-bowel atresia vary depending on the location of atresia. The diagnosis of prenatal small bowel obstruction and the identification of the site of obstruction may be useful for determining appropriate perinatal and operative management strategies.