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Objective: The clinical significance of bowel atresia may be diverse according to the location of atresia. There are several overseas studies on the small bowel atresia, but the study among Korean population is necessary because there is a racial difference in a subset of diseases. Our objective of this study was to investigate the differences in the perinatal outcomes between jejunal and ileal atresia detected with antenatal ultrasonography in Seoul National University Hospital.
Methods: Retrospective cohort study was conducted in patients who underwent antenatal check-up including ultrasonography and delivered in Seoul National University Hospital from January 1st in 2000 to December 31st in 2011. Jejunal and ileal atresia antenatally detected were confirmed with surgical operation after birth. Antenatal sonographic findings associated with jejunal and ileal atresia included dilatation in stomach, hyperechogenic contents in stomach, dilatation of small bowel, echogenic bowel, increased peristalsis of bowel, fetal ascites, bowel perforation, and polyhydramnios. For perinatal outcomes, gestational age at birth, birthweight, mechonium-stained amniotic fluid, Apgar score at 1 and 5 minute, cord blood arterial pH, NICU admission after birth, endotracheal intubation, duration of hospital stay associated with jejunal or ileal atresia, duration of total paranteral nutrition (TPN), and neonatal mortality were examined.
Results: Thirty-two newborns were diagnosed with jejunal (N=22) or ileal (N=10) atresia. There were no differences in maternal age, parity, the rate of Cesarean section, maternal diabetes mellitus and hypertensive disorders in pregnancy between the two groups. Cases with jejunal atresia were diagnosed earlier than those with ileal atresia by 4 weeks. In terms of antenatal sonographic findings, cases with jejunal atresia had a higher mean gestational age at birth and a higher rate of polyhydramnios than those with ileal atresia. Other antenatal sonographic findings were not different between the two groups. There were no differences in perinatal outcomes including gestational age at birth, birthweight, mechonium-stained amniotic fluid, Apgar score at 1 and 5 minute, cord blood arterial pH, NICU admission after birth, endotracheal intubation, duration of hospital stay associated with jejunal or ileal atresia, duration of TPN, number of surgery, timing of surgery, associated fetal abnormalities, and neonatal mortality between cases with jejunal and ileal atresia.
Conclusion: Perinatal outcomes between cases with jejunal and ileal atresia were not different, and there were no specific antenatal sonographic findings but the presence of polyhydramnios to tell the difference between jejunal and ileal atresia in the current study.