Intestinal Atresia
A congenital blockage or gap in part of a baby's intestine
Quick Facts
- Type: Congenital (present at birth) intestinal blockage
- Detected: Before birth or in newborn period
- Main symptom: Vomiting and no normal stool in a newborn
- Treatment: Surgery
Overview
Intestinal atresia is a birth defect in which a portion of a baby's intestine is missing, completely closed off, or narrowed so severely that food and fluids cannot pass through. The word atresia means a passage that is blocked or absent. It can occur anywhere along the small or large intestine, and it is named for where it happens, such as duodenal, jejunal, ileal, or colonic atresia.
Because a newborn with intestinal atresia cannot move milk and digestive contents through the bowel, the blockage causes problems soon after birth. Intestinal atresia is a surgical condition, and with timely surgery most babies recover well and go on to feed and grow normally.
Symptoms
Signs usually appear within the first day or two of life. Common symptoms in a newborn include:
- Vomiting, often green or yellow (bile-stained), especially after feeding
- A swollen or distended belly
- Failure to pass the first stool (meconium) or passing very little
- Feeding poorly or refusing to feed
- Signs of dehydration if vomiting continues
A newborn who is vomiting green fluid, has a swollen belly, or is not passing stool needs urgent medical evaluation, as these can signal a serious bowel blockage.
Causes
Most cases of intestinal atresia are thought to happen because the blood supply to part of the developing intestine is interrupted before birth. Without enough blood flow, that segment of bowel does not form properly, leaving a gap, a closed end, or a narrowed area.
- Blood flow interruption: The most common explanation for atresia in the small intestine.
- Developmental factors: In the duodenum (the first part of the small intestine), incomplete development of the channel during early pregnancy is often involved.
- Associated conditions: Duodenal atresia in particular is more common in babies with Down syndrome.
In most cases nothing the parents did caused the condition.
Risk Factors
- Down syndrome, especially for duodenal atresia
- Other birth defects of the abdomen, heart, or kidneys
- Cystic fibrosis, which can be linked to certain bowel blockages
- Conditions during pregnancy that affect blood flow to the developing bowel
- A family history in some rare inherited forms
Diagnosis
Intestinal atresia is sometimes found before birth and otherwise diagnosed shortly after delivery:
- Prenatal ultrasound: May show extra fluid around the baby (polyhydramnios) or dilated loops of bowel.
- Newborn examination: Assessing vomiting, belly swelling, and stool.
- X-rays: Abdominal X-rays can show the pattern of blockage, such as the classic appearance of duodenal atresia.
- Contrast studies: Special dye X-rays help locate the blockage and check the rest of the bowel.
Treatment
Intestinal atresia is treated with surgery, usually within the first days of life after the baby is stabilized.
- Stabilization first: A tube is placed to empty the stomach, and intravenous fluids correct dehydration and chemical imbalances.
- Surgery: A pediatric surgeon removes or bypasses the blocked segment and reconnects the healthy ends of the intestine.
- Nutrition support: Babies may receive nutrition through a vein for a time until the bowel heals and feeding can begin.
- Follow-up: Some babies, especially those who lose a long segment of bowel, need ongoing nutritional support and monitoring of growth.
Most children do well after surgery and can eat and grow normally, though recovery time varies with the length and location of the affected bowel.
Prevention
Intestinal atresia generally cannot be prevented because it develops during pregnancy for reasons outside anyone's control. General steps that support healthy pregnancy and early detection include:
- Attending all prenatal appointments and recommended ultrasounds
- Following prenatal care advice and taking prenatal vitamins as directed
- Planning delivery at a hospital with newborn surgical care if a blockage is suspected before birth
When to See a Doctor
Intestinal atresia is usually identified by the medical team in the hospital. After going home, contact a doctor promptly if a newborn vomits green or yellow fluid, has a swollen belly, is not passing stool, refuses to feed, or shows signs of dehydration such as fewer wet diapers and a dry mouth.
Seek emergency care right away if a baby has persistent green vomiting, a hard swollen abdomen, blood in the stool, or appears very unwell, as these can indicate a serious bowel problem.
Frequently Asked Questions
What is the first sign of intestinal atresia in a newborn?
Common early signs are vomiting that is often green or yellow, a swollen belly, and failure to pass the first stool. These usually appear within the first day or two of life and require urgent evaluation.
Did anything the parents do cause it?
In almost all cases, no. Intestinal atresia develops during pregnancy, most often because the blood supply to part of the bowel was interrupted while it was forming. It is not caused by anything a parent did or ate.
How is intestinal atresia treated?
It is treated with surgery, usually in the first days of life. After the baby is stabilized with fluids and a stomach tube, a surgeon removes or bypasses the blocked segment and reconnects the healthy intestine. Most babies recover and feed normally afterward.
Is intestinal atresia an emergency?
Yes. A blocked bowel in a newborn is a surgical emergency, because the blockage prevents feeding and can lead to dehydration, infection, or bowel damage if not treated. Green vomiting and a swollen belly in a newborn need immediate care.
Can a baby live a normal life after treatment?
Most babies do very well and grow and eat normally after surgery. Babies who lose a long segment of intestine may need extra nutritional support for a time, and their care team will monitor growth closely.
References
- MedlinePlus, U.S. National Library of Medicine. Intestinal obstruction in newborns.
- American Pediatric Surgical Association. Intestinal atresia.
- Mayo Clinic. Birth defects.
- Centers for Disease Control and Prevention (CDC). Birth Defects.