Presentation
Vomiting feeds. Initially passed meconium, but failure to pass normal amounts. Worsening abdominal distension.
Patient Data
Marked gaseous distension of proximal small bowel loops with an abrupt cut-off to the left of midline.
Nasogastric tube in situ.
Contrast fills distended bowel with abrupt cut-off in the region of the distal duodenum/proximal jejunum. There is beaking at the point of abrupt cut-off. Features here are of small bowel atresia.
Contrast per-rectum confirms a microcolon which is seen in disuse, e.g. where there is small bowel atresia.
Case Discussion
The dilated and obstructed proximal small bowel along with microcolon confirms the diagnosis of jejunal atresia. The fact that there was some meconium passed, and there are some filling defects in the colon suggest that the atresia has been the result of a relatively late ischemic cause.
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