The only treatment for intestinal atresia (IA) is surgery. Before surgery, your baby’s doctors will:
- Stabilize your baby’s health. If your baby has duodenal atresia, the doctor will check your baby for other problems such as heart defects and defects in the chromosomes.
- Insert a tube through your baby’s nose into the stomach (nasogastric tube, or NG tube). The tube empties the stomach and keeps gas out.
- Place an IV (intravenous) line, a tube that goes into a vein to replace fluids lost while your baby is vomiting or unable to eat.
Surgery for Intestinal Atresia
At the time of surgery, we will give your child medicine (general anesthesia) to make them sleep without pain. The doctors at Seattle Children’s who give your child anesthesia are board certified in pediatric anesthesiology. They have extra years of training in how to take care of children.
The surgeon will make a cut (incision) in your child’s belly (abdomen) and examine the intestine to find the part that is blocked. The surgeon may make a single incision (open surgery) or perform laparoscopic surgery. In laparoscopic surgery, the surgeon makes a few small incisions and inserts a small camera and other instruments to see the intestine and do the surgery.
Then, the surgeon will cut on both sides of the blocked sections and make openings that can be sewn together. This allows the intestine to become an open tube. Sometimes the surgeon has to remove parts of the intestine to correct the problem. Once the blockage is repaired, the surgeon will close the incision in the skin.
How long the surgery takes depends on your child’s needs. Before surgery, the surgeon can estimate how long your child’s operation will take. Most children who have this surgery are already in the Intensive Care Unit (ICU) before surgery. After surgery, they either go back to the ICU or to the recovery room. For babies, Seattle Children’s Level IV NICU (Neonatal Intensive Care Unit) provides the high level of care your baby needs. Seattle Children’s is the first hospital in Washington to have a Level IV NICU.
Gastrostomy for intestinal atresia
Some children may need to be fed through a tube placed into their stomach.
If your child’s surgeon suspects your child may have trouble feeding for a long time after surgery, the surgeon will talk with you about a gastrostomy (pronounced gas-STRAH-stuh-mee) tube (G tube) and will place it during the surgery for IA.
The surgeon makes an opening through the wall of your child’s belly. Then, the surgeon gently puts in a G tube or a device called a gastrostomy button. Both provide safe ways to give nutrition and medicine until your child can eat by mouth. You will be taught how to take care of the tube or button and how to feed your child through it.
Many babies do not need feeding tubes for very long, if at all. Instead of a G tube, these babies may have a temporary feeding tube placed through the nose into the stomach (NG tube). An NG tube is very small, soft and flexible, and babies tolerate it well.
With a G tube or NG tube, your baby can still eat by mouth if they are able and receive breast milk or formula through the feeding tube as needed.
After Surgery for Intestinal Atresia
After surgery, we will give your child pain medicine to make them comfortable. Most likely, your child will have an NG tube. They will get fluids and antibiotics through an IV.
Hospital stays vary after IA surgery. Most children will stay in the hospital for 2 to 4 weeks.Some children take longer to recover, especially if they have other health problems, birth defects or complications.
In some cases, it may take several weeks or longer for your child’s intestine to recover enough so that they can eat by mouth. Until that time, your child will get nutrition through a special IV called a peripherally inserted central catheter (PICC) line, through a feeding tube or through both. The surgery team will be able to give you an idea of how long your child will have these devices and what to expect with feeding.
By the time you go home, your child’s incision will be well healed. There are usually no restrictions on activity or bathing.
About 1 to 3 weeks after going home from the hospital, your child will see the surgeon for a follow-up visit. The surgeon will make sure your child is gaining weight and growing well. The surgeon will check to make sure there are no other health issues. During this visit, you and your child will probably also see a dietitian to help with feeding issues.
If you have questions about IA treatment, call our General and Thoracic Surgery Department at 206-987-2794, extension 4.