JEJUNAL ATRESIA WITH ABSENT MESENTERY AND A HELICAL ILEUM

1 January 1976

journal article
research article

Vol. 80 (5) , 550-553

Abstract

Of 59 human infants with jejunoileal atresia, 7 presented with absence of mesentery, the main superior mesenteric artery ceasing to exist beyond the origin of the right colic or ileocolic artery, and a helical ileum. This distinctive form of jejunal atresia was recognized with increasing frequency in recent years. Distal to the atresia, the small bowel receives its blood supply retrograde from an artery derived from the ileocolic or right colic arcades, and the ileum coils around its nutrient artery in an apple peel or Christmas tree deformity. The first 3 patients in this report died. The last 4 received parenteral hyperalimentation and were hospitalized over 4 mo. for malabsorption, but they recovered as their malabsorption gradually disappeared. The treatment included resection of the dilated bowel, as in other atresias. Resection of part of the distal bowel may be required for additional atresias or for poor vascularity with questionable viability. Postoperative malabsorption generally requires i.v. hyperalimentation.

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