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Type IIIb jejunal atresia treated surgically with two end-to-end anastomoses
  1. Alexander James Harper1,
  2. Susmit Das1,
  3. Emma Williamson1 and
  4. Rajesh Sah2
  1. 1Medicine, University of Leicester, Leicester, UK
  2. 2Paediatric Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal
  1. Correspondence to Alexander James Harper; alex.harper3{at}


A term newborn presented after birth with abdominal distension and vomiting in a developing country in Asia. Ultrasonography suggested intestinal obstruction and abdominal X-ray showed a ‘double-bubble’ sign suggestive of intestinal atresia. The newborn was diagnosed with early-onset neonatal sepsis secondary to intestinal obstruction and transferred to the neonatal intensive care unit. Surgery was performed and type IIIb jejunal atresia was found. Type IIIa/b jejunal atresia is associated with high incidence of poor outcome in lower socioeconomic countries. The affected intestinal segment and a distal serosal tear were resected and two end-to-end anastomoses formed. Oral feeding commenced on day 13 postoperatively. The patient was discharged on day 20 with adequate nutritional status. At follow-up, the patient continued to thrive. An operation involving resection of two different segments of bowel repaired with two end-to-end anastomoses in a neonate had a successful outcome for the patient.

  • Paediatric Surgery
  • Global Health
  • Paediatrics
  • Neonatal intensive care

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  • Contributors AJH, SD and EW all contributed equally to data collection, planning and writing of the manuscript. RS provided intraoperative figures, assisted in writing and reviewed the manuscript prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.