Intestinal Atresia

Intestinal atresia is a condition present at birth where part of your newborn’s intestine is narrowed, blocked or missing. This prevents food and fluid from moving through their intestine the way it should. Shortly after birth, signs of bowel blockage — like a swollen belly and vomiting — start to develop.

Intestinal atresia (pronounced “a-TREE-zhuh”) can occur anywhere along your baby’s gastrointestinal tract. But it most commonly affects their small intestine. Your baby’s small intestine helps digest food and absorb nutrients.

Without treatment, intestinal atresia can lead to nutritional issues and other serious complications. But with early diagnosis and treatment, most babies have very good outcomes with no further problems.

Intestinal atresia types

The type depends on where the blockage happens. The main types of intestinal atresia are:

• Duodenal atresia: This is the most common type. It affects the first part of your baby’s small intestine (duodenum). It makes up about half of all small intestinal blockages.
• Jejunal atresia: This type makes up about 1 in 5 cases. It affects the middle part of your baby’s small intestine (jejunum).
• Ileal atresia: This type also makes up about 1 in 5 cases. It affects the lower part of your baby’s small intestine (ileum).
• Colonic atresia: This is the rarest type. It affects any part of your baby’s large intestine (colon).

Intestinal atresia symptoms

Symptoms of intestinal atresia happen because food and other contents in your baby’s bowel build up behind the blockage. These symptoms usually appear within the first 24 to 48 hours of your newborn’s life. They may include:

• Abdominal swelling
• Vomiting (often green, yellow or brown bile)
• Not passing their first poop (meconium)
• Trouble feeding

What causes intestinal atresia?

Most of the time, intestinal atresia happens when something interrupts blood flow to the fetus’s intestine during development. Providers sometimes call this an in utero vascular accident. Without enough blood, part of the fetus’s intestine doesn’t form correctly.

Risk factors

Duodenal atresias are often linked to genetic conditions like Down syndrome. Other intestinal atresias are often only vascular-isolated issues.

Complications of this condition

Without treatment, intestinal atresia can lead to:

• Infection
• Feeding problems
• Poor growth
• Severe bowel blockage
• Death

How doctors diagnose this condition

Your healthcare provider may find intestinal atresia before or shortly after your baby is born.

During pregnancy, routine ultrasounds may show signs that suggest the condition, including:

• Polyhydramnios: This is the medical term for excess amniotic fluid in the uterus. It happens because the fetus can’t swallow and absorb the fluid properly.
• Dilated or bright (“echogenic”) bowel loops: This means parts of the fetus’s intestines look larger or brighter than usual on the ultrasound.
• Double bubble: This is a classic sign of duodenal atresia. It shows two fluid-filled areas: the fetus’s stomach and the first part of the duodenum.

After birth, symptoms of a bowel blockage may lead your newborn’s provider to request further testing. Tests may include:

• Abdominal X-rays
• Upper GI contrast study
• Contrast enema
• Blood tests
• Echocardiogram
• Kidney ultrasound

How do you repair intestinal atresia?

Intestinal atresia requires surgery after birth. A pediatric surgeon will remove the narrowed or blocked section of your baby’s intestine and reconnect the healthy ends so your baby’s bowel can work normally.

If your baby’s bowel isn’t in good shape at the operation, there’s sometimes a need for a temporary stoma.

Recovery time

Recovery time varies. Most babies gradually regain the use of their intestines over the next several days or weeks. You’ll slowly begin feeding your baby breast milk, or they’ll receive formula through a tube.

Some babies may need feedings through an IV (total parenteral nutrition). This is usually temporary until they can tolerate full feeds. Your baby’s healthcare team will also monitor your baby for complications, like:

• Infection
• Narrowing at the surgical site
• Short bowel syndrome

Providers often treat these complications successfully.

When should my baby see their healthcare provider?

Take your baby to see their provider right away if they’re not pooping or have any of the following symptoms:

• Swollen belly
• Vomiting
• Trouble feeding

What is the outlook (prognosis) for intestinal atresia?

Most babies do very well after surgery. Outcomes depend on:

• Which part of their intestine is affected
• How much intestine is involved
• Whether other conditions are present

Some babies with a complex atresia may need extra nutritional support. Some babies may develop late complications. But with early diagnosis and surgical treatment, most babies recover fully and go on to feed and grow normally.