Ileal Atresia Repair in Newborn

Ileal Atresia Repair in Newborn

Ileal atresia occurs when part of the small intestine (ileum) is not formed correctly. The ileum absorbs nutrients from food during digestion.

With ileal atresia, part of the ileum may be missing, or a part may be so narrow that food and liquid cannot move through it. This means that your baby cannot eat or drink normally.

Ileal atresia is a problem that a baby is born with (congenital defect). It can be fixed with surgery (ileal atresia repair). Surgery is usually done as soon as possible after birth, during the first few days of your baby’s life. Once your baby heals from surgery, your baby should be able to eat and drink normally.

Tell a health care provider about:

  • Any allergies that the baby or mother has.
  • Any problems that your baby’s family members have had with anesthetic medicines.
  • Any blood disorders that your baby’s family members have.
  • Any other medical conditions your baby has.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Bleeding.
  • Failure of food and liquid to pass through the ileum after the procedure.
  • Blockage of the ileum due to scar tissue.
  • Stomach contents coming back up into the throat (regurgitation).

What happens before the procedure?

  • A tube will be placed through your baby’s nose or mouth and down into his or her stomach. This may be called an NG tube (nasogastric tube) or an OG tube (orogastric tube). This tube removes air and fluid from the stomach.
  • A PICC line will be placed into a blood vessel in your baby’s inner elbow area. A PICC line is a small, thin tube (catheter) that connects to an IV. The PICC line provides:
    • Fluids and nutrition.
    • Antibiotic medicine to help prevent infection.

What happens during the procedure?

  • To lower your baby’s risk of infection, the health care team will:
    • Wash or sanitize their hands.
    • Clean your baby’s skin.
  • Your baby will be given a medicine to make him or her fall asleep (general anesthetic).
  • A tube will be inserted into your baby’s windpipe to help him or her breathe (breathing tube).
  • A small incision will be made in the upper part of your baby’s abdomen.
  • The blocked part of the ileum will be located using a tube that has a light and camera on the end of it (endoscopy). The camera sends images to a screen in the room.
  • Incisions will be made in the ileum above and below the blockage.
  • The upper part of the ileum (above the blockage) will be cut and reattached to the lower part of the ileum (below the blockage). The connection will be made with stitches (sutures) or staples.
  • The incision in your baby’s abdomen will be closed with sutures and covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your baby will recover in the NICU (neonatal intensive care unit) in a warm crib (isolette). The length of time spent in the NICU varies depending on your baby’s condition.
  • Your baby will continue to have:
    • A PICC line in the inner elbow area to provide fluids, nutrition, and antibiotics.
    • An NG tube or OG tube in the nose or mouth.
  • Your baby’s breathing tube may be removed soon after your baby wakes up. In some cases, it may stay in place for a few days, depending on your baby’s condition.
  • After a few days, tests will be done to check how the ileum is functioning. Your baby’s health care provider will:
    • Inject dye through a vein and into your baby’s bloodstream, and then take X-rays. The X-rays will show how the dye moves through the ileum.
    • Listen for sounds in your baby’s abdomen that mean that air and fluid are passing through the ileum and the rest of the digestive tract (bowel sounds).
    • Take X-rays to see how air and fluids pass through the ileum.
  • After your baby has normal test results, or has a bowel movement:
    • Your baby’s tubes will be removed.
    • Your baby may start feedings with formula or with pre-pumped (expressed) breast milk.
    • Your baby may be able to go home after he or she can eat without any problems.

Summary

  • Ileal atresia occurs when a baby’s intestine is not formed correctly, which results in difficulties with digestion and feeding.
  • Surgery is the only treatment and will be done during the first few days of life.
  • After surgery, your baby should be able to eat and drink normally.

Ileal Atresia Repair, Newborn, Care After

This sheet gives you information about how to care for your baby after his or her procedure. Your baby’s health care provider may also give you more specific instructions. If you have problems or questions, contact your baby’s health care provider.

What can I expect after the procedure?

After the procedure, it is common for babies to have:

  • Abdominal swelling.
  • Gas.
  • Frequent spitting up.

Follow these instructions at home:

  • Bathe and feed your baby as told by your baby’s health care provider. If your baby has trouble feeding, you may need to work with a nutrition and feeding therapist.
  • Give your baby over-the-counter and prescription medicines only as told by his or her health care provider.
  • Follow instructions from your baby’s health care provider about how to take care of your baby’s incision. Make sure you:
    • Wash your hands with soap and water before you change your baby’s bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Change your baby’s dressing as told by your health care provider.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your baby’s health care provider tells you to do that.
  • Check your baby’s incision area every day for signs of infection. Check for:
    • Redness or swelling.
    • Fluid or blood.
    • Warmth.
    • Pus or a bad smell.
  • Keep all follow-up visits as told by your baby’s health care provider. This is important. Your baby will need to have checkups on a regular basis.

Contact a health care provider if your baby:

  • Has problems feeding or refuses to feed.
  • Is vomiting or spitting up with each feeding.
  • Has redness or swelling around the incision.
  • Has fluid or blood coming from the incision.
  • Has pus or a bad smell coming from the incision.
  • Is not gaining weight as expected.

Get help right away if your baby:

  • Has a temperature of 100°F (38°C) or higher.
  • Is not making stool or passing urine.

Summary

  • If your baby has trouble feeding, work with a nutrition and feeding therapist as recommended by your health care provider.
  • Check your baby’s incision area every day for signs of infection, such as redness or swelling.
  • Your baby will need to have checkups on a regular basis. It is important to keep all of your baby’s follow-up visits.
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