Jejunal atresia is a
birth defect in a newborn characterized by partial or complete absence of the membrane connecting the small intestines to the abdominal wall (the mesentery). It causes a portion of the small intestines (the jejunum) to twist around an artery that supplies blood to the colon (the marginal artery). This leads to an intestinal blockage or "
atresia." Common symptoms in the newborn include feeding difficulties,
failure to thrive, vomiting bile (a yellowish-green fluid), abdominal swelling, and/or absence of
bowel movements after birth. It typically occurs
sporadically in people with no
family history of the condition; however, more than one family member can rarely be affected, suggesting that there may be a genetic component in some cases. Jejunal atresia is typically treated with surgery.
[1][2]
Last updated: 10/26/2016
Short bowel syndrome is a
disorder characterized by malabsorption of nutrients due to problems involving the small intestine.[3] The small intestine is the tube-shaped
organ between the stomach and large intestine, which includes the duodenum, jejunum, and ileum, where most food digestion and nutrient absorption take place. The causes of short bowel syndrome in adults include
Crohn disease,
mesenteric ischemia,
radiation enteritis, or surgical removal of half or more of the small intestine to treat intestinal diseases or injuries. In children the main causes include
necrotizing enterocolitis,
intestinal atresias, and
intestinal volvulus.
[4] Signs and symptoms may include diarrhea, cramping, bloating, heartburn, dehydration, malnutrition, weight loss, food sensitivities, weakness, and fatigue. Examples of treatment include diet and nutritional support, intestinal surgeries, and, in some cases, intestinal transplantation.
[3]
Last updated: 6/22/2017
People with short bowel syndrome can lead a productive, lengthy, and happy life if their condition is managed appropriately.
[5] Predictors of the overall long term
prognosis of children with small bowel syndrome is influenced by the size and location of the resected intestine (i.e., whether it involves the ileocecal valve, duodenum, jejunum, or ileum),
[6][7] and the development of liver disease (e.g.,
cholestasis).
[7] The following free full-text articles provide further details regarding factors affecting long-term prognosis:
Spencer AU et al.,
Pediatric short bowel syndrome: Redefining predictors of success.
Ann Surg. 2005 Sept;242(3):403-412.
Brizee LS. Short Bowel Syndrome. University of Washington. 2007. Available at:
http://depts.washington.edu/growing/Assess/SBS.htm
Initially, all people with short bowel syndrome require
total parenteral nutrition (TPN). The goal of treatment is to gradually decrease the requirement for TPN and at best, to eliminate its need.
Some children with short bowel syndrome are able to eat by mouth and digest food in a matter of weeks to months
[6] (optimal adaption of the intestine may evolve over the course of 1 to 2 years).
[5] Your child's physician should counsel you regarding your child's nutritional status, treatment, and goals. Once children are able to eat, their doctor will likely recommend some modifications to their diet, and possibly vitamin and other nutrient supplementations.
Children who are off of parenteral nutrition support still remain at risk for dehydration, bacterial overgrowth, and nutritional deficiencies. As a result they require long-term, regular monitoring. Symptoms of
gastroenteritis should be reported to their doctors right away. Regular treatment with
antibiotics to treat/prevent infections is often required.
[6]
Despite careful treatment, some children with short bowel syndrome have very poor digestion and are unable to get adequate nutrients from diet alone. These children require long term TPN. In addition to the risks described above (i.e., dehydration, bacterial overgrowth, nutritional deficiencies), there are a number of additional challenges that can occur with long term TPN use (e.g.,
catheter infection, liver disease). The Oley Foundation exists to provide people on TPN and their families with information and support. The Foundation may be a helpful resource for learning more about long term prognosis and quality of life impacts of long term TPN use:
The Oley Foundation
214 Hun Memorial, MC-28
Albany Medical Center
Albany, NY 12208-3478
Toll-free: 1-800-776-OLEY
Phone: 1-518-262-5079
Fax: 1-518-262-5528
Web site:
http://www.oley.org/
Last updated: 6/8/2011
Last updated: 6/8/2011
