Jejunal atresia

Last revised by Joshua Yap on 4 Oct 2023

Jejunal atresia is a congenital anomaly characterized by obliteration of the lumen of the jejunum. The site of the atresia can be anywhere from the ligament of Treitz to the jejunoileal junction. There can be more than one atretic segment.

This article will focus on jejunal atresia alone, however, it is important to note that some cases correspond to jejunoileal atresia and show a mixed pattern, including the ones discussed in the ileal atresia article. 

Jejunal atresia has an incidence of about 1:1000 live births and is more common than duodenal atresia.

Neonates typically present with abdominal distension and bilious vomiting within the first 24 hours of birth. These symptoms, however, do not allow for differentiation from duodenal atresia.

The etiology is thought to be from an ischemic event in utero.

The classic radiographic sign of jejunal atresia is the triple bubble sign of a proximal obstruction; it is equivalent to the double bubble sign of duodenal atresia with a third bubble caused by jejunal distention with air.

There can be multiple dilated small bowel loops proximal to the atresia, and the number of dilated loops increases as the point of atresia becomes more distal.

Contrast enema typically shows a microcolon (small unused colon).

On plain radiograph consider:

On contrast enema consider:

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Cases and figures

  • Case 1a: triple bubble sign
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  • Case 1b: unused microcolon
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  • Case 2
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