2006, Number 5
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Rev Invest Clin 2006; 58 (5)
Co-morbidity and mortality during the first year of life in children with jejunoileal atresia
García H, Franco-Gutiérrez M, Rodríguez-Mejía EJ, González-Lara CD
Language: Spanish
References: 28
Page: 450-457
PDF size: 71.55 Kb.
ABSTRACT
Objective. To identify the co-morbidity and mortality during the first year of life in children with jejunoileal atresia.
Design. Descriptive, comparative cohort.
Site. Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social.
Population. Seventy children with jejunoileal atresia.
Measures. Following variables were registered: gestational age, birth weight, sex, type and site of atresia, other congenital defects, surgical management, number of surgeries, duration of fasting, re-hospitalizations, weight and height at 6 months and one year of life, co-morbidity and mortality.
Results. Intestinal atresia types I and II were present in 27% of the patients respectively and type IIIa in 24%. Co-morbidity in the neonatal period was 64.2%, being the most common conditions sepsis (47.1%) and anastomotic stricture (18.5%). During the first year of life co-morbidity was 51.4%, presented as functional intestinal obstruction (21.4%). Mortality was 11.4% (n = 8), the main causes of death were sepsis (n = 6) and liver failure (n = 2). The mortality rate according to the type of atresia was 44.4% for type IV, 33.3% for type IIIb and 1.3% for type I.
Conclusions. Co-morbidity during the first year of life in children with jejunoileal atresia is high, and related to infections and anastomosis inherent problems. Mortality is higher for intestinal atresia type IV.
REFERENCES
Prasad S, Bajpai M. Intestinal atresia. Indian J Pediatr 2000; 67: 671-8.
Haller JA, Tepas JJ, Pickard LR, Shermeta DW. Intestinal atresia: current concepts of pathogenesis, pathophysiology, and operative management. Am Surg 1983; 49: 385-91.
Low JH, Barnard CN. Congenital intestinal atresia: observations on its origin. Lancet 1955; 2: 1065.
Baglaj SM, Czernik J, Kuryszko J, Kuropka P. Natural history of experimental intestinal atresia: morphologic and ultraestructural study. J Pediatr Surg 2001; 36: 1428-34.
Santulli TV, Blanc WA. Congenital atresia of the intestine: pathogenesis and treatment. Am Surg 1961; 27: 154-959.
Abrams JS. Experimental intestinal atresia. Surgery 1968; 64: 185-91.
Cragan JD, Louise MM, Moore CA, Khoury MJ. Descriptive epidemiology of small intestinal atresia, Atlanta, Georgia. Teratology 1993; 48: 441-50.
Rescorla FJ, Grosfeld JL. Intestinal atresia and stenosis: Analysis of survival in 120 cases. Surgery 1985; 98: 668-76.
Sato S, Nishijima E, Muraji T, Tsugawa C, Kimura Ken. Jejunoileal atresia: A 27 year experience. J Pediatr Surg 1998; 33: 1633-5.
Martín LW, Zerella JT. Jejunoileal atresia: A proposed clasification. J Pediatr Surg 1976; 11: 399-403.
Grosfeld JL, Ballantine TV, Shoemaker R. Operative management of intestinal atresia and stenosis based on pathologic findings. J Pediatr Surg 1979; 14: 368-75.
Toloukian RJ, Smith GJ. Normal intestinal length in preterm infants. J Pediatr Surg 1983; 18: 720-3.
De Lorimier AA, Fonkalsrud EW, Hays DM. Congenital atresia and stenosis of the jejunum and ileum. J Pediatr Surg 1969; 5: 819-27.
Shah R, Woolley MM. Gastroschisis and intestinal atresia. J Pediatr Surg 1991; 26: 788-90.
Snyder CL, Miller KA, Sharp RJ, Murphy JP, Andrews WA. Management of intestinal atresia in patient with gastroschisis. J Pediatr Surg 2001; 36: 1542-5.
Gleason PF, Eddleman KA, Stone JL. Trastornos gastrointestinales del feto. Clin Perinatol 2000; 4: 927-31.
Mews C, Sinatra FR. Cholestasis in infancy. Pediatr Rev 1994; 15: 156-9.
Ogden C, Kuczmarski RJ, Flegal KM, Mei Z, Guo S. Centers for Disease Control and Prevention 2000 Growth Charts for the United States: Improvements to the 1977 National Center for Health Statistics Version. Pediatrics 2002; 109: 45-60.
Marks KH, Maisels MJ, Moore E, Gifford K, Friedman Z. Head growth in sick premature infants: a longitudinal study. J Pediatr 1979; 94: 282-5.
Babson SG, Benda GI. Growth graphs for the clinical assessment of infants of varying gestational age. J Pediatr 1976; 89: 814-20.
Vecchia D, Laura K, Grosfeld JL, West KW, Rescorla FJ, Scherer LR, Engum SA. Intestinal atresia and stenosis: A 25-year experience with 277 cases. Arch Surg 1998; 133: 490-7.
Surana R, Puri P. Small intestinal atresia: Effect on fetal nutrition. J Pediatr Surg 1994; 29: 1250-2.
Masumoto K, Suita S, Nada O, Taguchi T, Guo R. Abnormalities of enteric neuron, intestinal pacemaker cells, and smooth muscle in human intestinal atresia. J Pediatr Surg 1999; 34: 1463-8.
Tovar JA, Suñol M, López de Torre B, Camarero C, Torrado J. Mucosal morphology in experimental intestinal atresia. J Pediatr Surg 1991; 26: 184-9.
Doolin EJ, Ormsbee HS, Hill JL. Motility abnormality in intestinal atresia. J Pediatr Surg 1987; 22: 320-4.
Gornall P. Management of intestinal atresia complicating gastroschisis. J Pediatr Surg 1989; 24: 522-4.
Fleet MS, de la Hunt MN. Intestinal atresia with gastroschisis: A selective approach to management. J Pediatr Surg 2000; 35: 1323-5.
Waldhausen JH, Sawin RS. Improved long-term outcome for patients with jejunoileal apple peel atresia. J Pediatr Surg 1997; 32: 1307-9.