Digestive and Gastrointestinal Conditions

Intestinal Atresia

What is intestinal atresia?

Intestinal atresia (IA) is a condition that occurs when part of your child’s intestine doesn’t form completely. Instead of being an open tube, the intestine is closed off in 1 or more places. Some children are missing segments of the intestine between the closed spots. IA prevents food and stool (feces) from moving through your child’s body, which can lead to symptoms like swelling and vomiting.

  • The severity of IA varies. Your child may have just a small blockage, or they may be missing large segments of intestine. IA is most common in the small intestine, but it can happen in the large intestine. Doctors sometimes describe IA by naming the part of the intestine it affects. IA can be in: 

    • The first part of the small intestine, called the duodenum (pronounced due-ODD-en-um)
    • The middle part of the small intestine, called the jejunum (pronounced jeh-JUNE-um)
    • The last part of the small intestine, called the ileum (pronounced ILL-ee-um)
    • The large intestine, called the colon
  • IA is present when your baby is born (congenital).

    IA in the duodenum, called duodenal atresia, is due to a problem in the way the duodenum forms while your baby is developing. It may be linked with problems in other parts of the body. About 1 in 2,500 babies has duodenal atresia.

    IA in other parts of the intestine usually is caused by the loss of blood supply to that part. Atresia in the jejunum, ileum or colon is linked to atresia in other parts of the intestine. About 1 in 1,000 babies has jejunal or ileal atresia.

Intestinal Atresia at Seattle Children’s

We have treated many hundreds of children with IA. Our surgeons are experienced at performing the surgery that creates an intestine and allows food and stool to pass so these children can thrive. Each year, we take care of about 20 to 30 babies with IA.

Sometimes doctors suspect a baby may have IA based on a routine ultrasound before the baby is born. This is most common with duodenal atresia. If this happens with your baby, the team at Seattle Children’s Prenatal Diagnosis and Treatment Program can work with you to get ready for the birth and plan for the surgery your baby will need.

  • We do more minimally invasive procedures on children for a broader range of conditions than any hospital in the region. After this type of surgery, your child is likely to heal faster with less pain and go home from the hospital sooner.

    Children react to illness, injury, pain and medication differently than adults. They require – and deserve – care designed specifically for them. Our pediatric experts understand how treatments today affect growing bodies in the future and are specially trained to meet the needs of children and teens.

    We provide the right care, at the right time. We are committed to avoiding unnecessary diagnostic tests, radiation and surgery. Radiation doses at Seattle Children’s are consistently lower than the guidelines recommended by the American College of Radiology.

    Seattle Children’s is 1 of just 5 hospitals nationwide whose commitment to preventing and relieving kids’ pain has been recognized by ChildKind International.

  • When it comes to your child’s health, experience matters. Our surgical teams have the skills to do it right the first time, to handle the unexpected and to care for children with the rarest conditions.

    More cases mean greater surgical expertise and a sharper ability to determine if surgery is even necessary. All that adds up to better outcomes.

  • When you come to Seattle Children’s, you have a team of people to care for your child before, during and after surgery. Along with your child’s surgeon, you are connected with nurses, dietitians, child life specialists and others. We work together to meet all of your child’s health needs and help your family through this experience.

    We work with many children and families from around the Northwest and beyond. Whether you live nearby or far away, we can help with financial counseling, schooling, housing, transportation, interpreter services and spiritual care. Learn about our services for patients and families.

Symptoms of Intestinal Atresia

Symptoms of intestinal atresia (IA) may first show up before a baby is born. One sign of IA is extra amniotic fluid around the baby inside the mother’s womb. This condition is called polyhydramnios (pronounced pahl-ee-hi-DRAM-nee-us). It occurs because the baby’s intestines don’t absorb the typical amount of amniotic fluid. This condition sometimes shows up on an ultrasound before the baby is born.

Symptoms of IA show up within the first 1 to 2 days after birth. Babies with IA may have 1 or more of these symptoms:   

  • No stool passed (bowel movement)
  • Swollen belly from gas
  • Vomiting; vomit may be yellow or greenish in color
  • Does not want to eat

Diagnosing Intestinal Atresia

To find out if your baby has IA, the doctor will ask for imaging tests. Your baby may have: 

  • A regular X-ray of the belly. Regular X-rays may show signs of IA, including bubbles of fluid and air in the stomach and first part of the intestine or no air in other parts of the intestine.
  • A series of X-rays called a contrast study. In contrast studies, doctors put a liquid that contains a dye into your baby’s large intestine (colon). The dye helps your baby’s intestine show up on X-ray film. In some cases, the dye goes in the baby’s stomach. Either the baby drinks the liquid or doctors place a small tube into the stomach to deliver the dye.

Treating Intestinal Atresia

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 intravenous (IV) 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. This means they have extra years of training in how to give anesthesia to children safely.

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 Neonatal Intensive Care Unit (NICU) provides the high level of care your baby needs.

  • 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, or 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.

    If placing a feeding tube, 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, we will give your child pain medicine to make them comfortable. They will get fluids and antibiotics through an IV.

    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.

    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.

Contact Us

Contact our Pediatric General and Thoracic Surgery Department at 206-987-2794, extension 4, for an appointment, second opinion or more information about pectus carinatum.

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