Over a period of 19 years 22 children with
intestinal atresia and
stenosis were managed at the Ahmadu Bello University Teaching Hospital Zaria. The condition ranks as the fourth most common cause of neonatal
intestinal obstruction after
anorectal malformation,
Hirschsprung's disease and strangulated
inguinal hernia at the hospital. Three patients had
duodenal atresia, 18 had jejunoileal involvement (atresia 15,
stenosis 3) and one colonic atresia. The median age at presentation to the surgeon was 6 days (range 1 day-2 years). The common features were bilious
vomiting and abdominal distension, the latter being more common in patients with lower atresia. Non-passage of meconium in the first 24 hours of birth occurred in 11 patients; mostly in those with lower jejunal, ileal and colonic involvement. Eight patients had associated anomalies, 5 of them with ileal atresia or
stenosis. Diagnostic investigation was mainly plain abdominal radiography showing double-bubble shadow in
duodenal atresia and varying degrees of air-fluid levels in other atresias. Contrast studies were not employed for diagnosis in any patient. The patients with
duodenal atresia and had duodenoduodenostomy and duodenojejunostomy respectively while the jejunoileal atresia and
stenosis were treated by resection and anastomosis. One patient with ileal atresia associated with total colonic
Hirschsprung's disease and extensive atresia from terminal ileum down to descending colon had
ileostomy. Postoperatively, 7 patients had
infections of varying degrees and 3 anastomotic dehiscence. Mortality was 9 (41%) due mostly to septic complications and prematurity. While the survival of children with
intestinal atresia and
stenosis has improved over the years in developed countries, ours is still low (59%) due to late presentation and lack of
neonatal intensive care facilities.