Abstract
Purpose: To clarify the present states of incidence, treatment, length of hospital stay and prognosis of apple-peel-type intestinal atresia in Chugoku Shikoku pediatric surgery facilities, we report the results of a questionnaire survey.
Methods: A questionnaire survey of the member institutions of the Chugoku Shikoku Pediatric Surgical Congress was carried out. The questionnaire included the clinical features of patients who have been diagnosed as having apple-peel-type small intestinal atresia on the basis of operative findings from January 1990 to December 2013.
Results: Information was obtained from 13 institutions. The total number of cases of small intestinal atresia was 203. Among these, apple-peel-type atresia was confirmed in 17 patients (8.4%, 6 boys and 11 girls). The mean gestational age was 35 weeks 2 days and the mean body weight at birth was 2,315 g. Prenatal diagnosis was made in 13 patients (76.5%). The average period of parenteral nutrition was 68.8 days (8–313 days) and the average period of hospitalization was 98.8 days (19–218 days). Primary surgery was performed in 13 patients (76.5%); out of the 13 patients, re-do surgery was required in four patients (30.8%). All the patients survived without long-term complications, and the mean body weights were 8.4 kg at one year of age and 12.6 kg at three years of age.
Conclusions: All patients presenting with apple-peel-type small intestine atresia survived without long-term complications. Primary surgery is possible in patients with good condition; however, sufficient attention must be paid to anastomosis. Moreover, it is important to consider the possibilities of sepsis, cholestasis and short bowel syndrome, and that anastomotic leakage and stenosis increase the risk of liver dysfunction and icterus.
