GI atresia

[size=6]A 36-week gestational age baby was found to have intestinal atresia as pictured below. There is proximal jejunal atresia and approximately 60 cm of distal small intestine with an intact ileocecal valve. The most appropriate surgical management is: a End-side anastomosis b Delayed primary anastomosis c Proximal jejunostomy d Functional end-end anastomosis[/size]

[size=6]A 2-day-old infant is in the newborn nursery with persistent nonbilious emesis and intolerance of feeds. A chest radiograph was obtained which is shown below. Based upon this imaging an upper GI study was obtained showing no progression of contrast beyond the stomach after 1 hour (below). What is the most commonly reported condition associated with this diagnosis? a Ventricular septal defect b Vertebral anomalies c Renal agenesis d Epidermolysis bullosa e Intestinal atresia[/size]

[size=6]You explore a 3.6 kg, 36 week old male infant with concern for intestinal atresia. At the time of the operation, you discover a Type IIIb jejunal atresia as noted in the below picture. There is only 30 cm of well-perfused bowel proximal dilated bowel prior to the atretic segment. This proximal bowel is dilated up to 5 cm from the ligament of Treitz. The most appropriate management of the dilated proximal bowel is: a Resect the dilated bowel b Perform end jejunostomy c Perform a tapering enteroplasty followed by anastomosis d Leave the child in discontinuity and manage with TPN e Perform a neonatal STEP procedure[/size]

Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "The ischaemic insult also adversely influences the structure and subsequent function of the remaining bowel. Histological and histochemical abnormalities can be observed up to 20 cm cephalad from the end of the atretic proximal segment. The distal bowel is unused and potentially normal in function."

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A 1-day old baby girl, born at 35 weeks of gestation, presents with bilious emesis. The abdomen is soft and not distended. Plain abdominal films and a contrast enema are shown. At exploration, you find Type IIIA jejunal atresia with 15 cm of jejunum (3 cm in diameter) and 4 cm of ileum. What operation will you perform?

A term baby girl presents with a neonatal bowel obstruction soon after birth. Dilated, echogenic bowel was seen on Ultrasound at 32 weeks gestation. Both parents are carriers of the cystic fibrosis gene. Her abdominal films and contrast enema are shown. During the contrast enema, the radiologist did not attempt to reflux the contrast into the distended bowel loops. How would you manage this patient?

A female fetus is followed for a dilated, hyperperistaltic bowel loop persistent until birth. Films at 4 & 10 hours of life are shown. The baby has a normal exam, but she vomits bile after first feeding. Contrast enema and UGI performed simultaneously are read as normal. What would you do next?

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Any one want a high quality PDF of this chart, post in this thread and use a personalized picture as an avatar, I will send it to you in a private message Edit: available without restrictions

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[size=20px]Which of the following is not true about jejunal atresia? A It is considered to be due to an in utero ischaemic insult. B It comprises approximately 50% of small-bowel atresia. C It can be associated with other jejunal and ileal atresia. D Contrast study is seldom required. E It is usually associated with multiple anomalies.[/size]

First one with correct answer with justification win. At day of life one, a 39 week gestational age healthy baby presents with abdominal distention and vomiting after two feeding attempts. The emesis is green tinged. An abdominal radiograph and lower intestinal contrast study are obtained as shown. [center] [/center] [size=20px]Operative management of this patient with bilious vomiting must include A rectal biopsy. B diverting ostomy. C intestinal resection and primary anastomosis. D appendectomy. E Ladd procedure.[/size]

First one with correct answer with justification win. A one-day old, 36-week gestation infant is admitted to the neonatal intensive care unit (NICU) with bilious vomiting and abdominal distention. On exam, the infant is fussy but in no acute distress and the abdomen is soft but distended. Abdominal films suggest a proximal jejunal obstruction consistent with a jejunal atresia. [size=20px]At laparotomy, a proximal jejunal atresia with significant dilation is found. Distally there is loss of small bowel consistent with an in utero volvulus and a string of sausage (i.e. type IV) segments of atretic small bowel with each of five segments of bowel measuring between t…

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