one should look rule out the presence of asplenia/polysplenia or biliary atresia at the
time of exploration.
Trisomy 21 is seen in 30% of patients with duodenal atresia. As such, when
duodenal atresia is seen in patients with Trisomy 21, anomalies that are associated
with Trisomy 21 should be ruled out (including cardiac defects—AV canal—and
Hirschprung disease.
Jejunal/ Ileal Atresia
The pathogenesis of jejunoileal atresias is thought to be due to vascular
insufficiency of an intestinal segment. Ileal atresia is the most common intestinal
atresia. Jejunoileal atresias may be seen inn 15% of gastroschisis patients. Atresias
may also be seen in patients with meconium ileus. Multiple atresias may occur. Small
intestinal atresias may give rise to small bowel syndrome.
Colon Atresia
Colon atresias may be associated with Hirschprung disease (2%). The atretic
segment is typically located in the hepatic flexure. A suction rectal biopsy should be
performed before gastrointestinal continuitiy is re-established in patients with colon
atresias.
Management of Atresias