Definition
Definition
Intestinal atresia repair is a surgery to fix a birth defect of the small or large intestine. The surgery removes the obstructed part of intestine and reconnects the healthy ends.
Multiple procedures may be needed to complete this repair if a large area of the intestine is affected.
Reasons for Procedure
Reasons for Procedure
Intestinal atresia is an area of the intestine that has not formed correctly and is completely closed off. The affected area makes it impossible for food or liquid to pass through the intestines. Food cannot be properly digested or passed out of the body. Intestinal atresia needs to be treated immediately for the baby’s survival.
Normal Anatomy of the Abdominal OrgansCopyright © Nucleus Medical Media, Inc.
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Possible Complications
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. The doctor will review potential problems, like:
- Ileus—intestinal movements stop which may cause back-up
- Bleeding
- Infection
- Leakage from the intestinal connection site
- Short bowel syndrome—nutritional problems if a large segment of small intestine was removed
- Adhesions or scarring, which may cause blockage
- Vitamin deficiencies
- Blind loop syndrome–overgrowth of small intestinal bacteria
What to Expect
What to Expect
Prior to Procedure
If the atresia is suspected before birth, a plan will be made to make repairs soon after the baby is born. Repairs cannot be made prior to the baby’s birth.
After birth, supportive steps before the surgery may include:
- IV fluids and nutrition
- Nasogastric tube to remove excess air in the stomach and intestines
Anesthesia
General anesthesia is used. The baby will be asleep during the procedure.
Description of the Procedure
The extent of the surgery depends on how much of the intestine is affected. An incision will be made in the abdomen. The damaged intestine will be located and removed. The healthy ends of the intestine will be connected. When the corrections are done the incision will be closed with stitches and/or staples. The incision will be covered with a bandage.
Sometimes the remaining intestines need time to recover or cannot be reconnected right away for another reason. In that case, an opening may be made in the skin and abdominal wall. The upper part of the remaining intestine is attached to this opening to form a stoma. The stoma will allow digested food to pass out of the body into an attached bag so that the lower intestine can heal.
Future surgeries may be needed to reconnect the healthy intestines if a stoma was made or to complete additional repairs once the baby is healthier.
Immediately After Procedure
The baby will be taken to a recovery room and monitored.
How Long Will It Take?
It depends on how much repair is needed.
How Much Will It Hurt?
Anesthesia prevents pain during surgery. Additional medication will be given to relieve pain or soreness during recovery.
Average Hospital Stay
The length of stay depends on the extent of the repair needed. Proper feeding, weight gain, and bowel function are needed before the baby can go home. This may take several weeks.
Post-procedure Care
At the Hospital
A neonatal intensive care unit will monitor blood pressure, pulse, and breathing. Recovery may also include:
- Pain medications
- Antibiotics to prevent infection
- IV fluids and nutritional support
The hospital staff will take steps to reduce the chance of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your baby’s incisions covered
There are also steps you can take to reduce your baby’s chances of infection such as:
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding their healthcare providers to wear gloves or masks
- Not allowing others to touch your baby’s incisions
At Home
Recovery may take some time and require a special diet. Your baby’s growth and overall health will be monitored to make sure the baby has adequate nutrition.
Call Your Doctor
Call Your Doctor
It is important to monitor your baby’s recovery after they leave the hospital. Alert your baby’s doctor to any problems. If any of the following occur, call your baby’s doctor:
- Signs of infection, including fever or chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- New or worsening symptoms
Call for emergency medical service right away if your baby has:
- Difficulty breathing
- Signs of bowel obstruction
- High fever
- Localized abdominal tenderness
- Abdominal swelling or hardness
- Green or yellow vomit
If you think your baby has an emergency, call for emergency medical services right away.
RESOURCES:
March of Dimes http://www.marchofdimes.org
CANADIAN RESOURCES:
Public Health Agency of Canada http://www.phac-aspc.gc.ca
References:
http://www.cincinnatichildrens.org/health/i/obstructions
Updated November 2013. Accessed March 13, 2015.
Intestinal atresia and stenosis in children. Boston Children’s Hospital website. Available at:
http://www.childrenshospital.org/conditions-and-treatments/conditions/intestinal-atresia-and-stenosis
Accessed March 13, 2015.
Intestinal atresia or stenosis. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated January 7, 2015. Accessed March 13, 2015.
Intestinal atresia treatment. Seattle Children’s website. Available at:
http://www.seattlechildrens.org/medical-conditions/digestive-gastrointestinal-conditions/intestinal-atresia-treatment
Accessed March 13, 2015.
Surgical repair of the small bowel. The Children’s Hospital of Philadelphia website. Available at:
http://chop.edu/treatments/surgical-repair-small-bowel-atresia#.VQMWfdJ4pcQ
Accessed March 13, 2015.