Intestinal Atresia Repair in Newborn

What is Intestinal Atresia Repair in Newborn

Intestinal atresia repair is a surgical procedure to fix a blockage (atresia) that can occur in various areas of the small intestine. The small intestine is part of the digestive tract that includes the duodenum, jejunum, and ileum.

Food and liquids normally move from the stomach into the small intestine during the process of digestion. If your baby’s small intestine is blocked, it means liquid cannot move out of your baby’s stomach.

Intestinal atresia is a condition that some children are born with (congenital). It can be diagnosed before birth by a routine test done during pregnancy using sound waves and a computer (ultrasound). Your baby’s health care provider may also suspect intestinal atresia if your baby vomits shortly after birth.

Tell a health care provider about:

  • Any allergies your baby has.
  • All medicines your baby is taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you, your baby or family members have had with anesthetic medicines.
  • Any blood disorders your baby has.
  • Any surgeries your baby has had.
  • Any medical conditions your baby has.

What are the risks?

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

  • Failure of feedings to pass through the digestive tract.
  • Future blockage that may occur due to scar tissue from the surgery.
  • Leaking digestive fluids from the surgical area.
  • Infection.
  • Vomiting.
  • Allergic reactions to medicines.
  • Bleeding.

What happens before the procedure?

Tube and catheter placement

  • As soon as your baby is diagnosed with intestinal atresia, a nasogastric tube (NG tube) will be placed through your baby’s nose or mouth and into his or her stomach. The NG tube will remove air and fluid from the stomach. This will stay in place until your baby’s health care provider approves its removal.
  • A soft tube (catheter) will be put into one of your baby’s veins.
    • Fluids and nutrition will be given through the catheter because your baby will not be able to feed.
    • Antibiotic medicines and vitamins will also be given through the catheter.
    • The catheter will stay in place until your baby’s health care provider approves its removal.

Staying hydrated

  • Follow instructions from your baby’s health care provider about hydration, which may include:
    • Up to 2 hours before the procedure – your baby may continue to drink clear liquids, such as water or clear fruit juice.

Eating and drinking restrictions

  • Follow instructions from your baby’s health care provider about eating and drinking, which may include:
    • 6 hours before the procedure – have your baby stop drinking formula or milk.
    • 4 hours before the procedure – stop giving your baby breast milk.
    • 2 hours before the procedure – have your baby stop drinking clear liquids.

General instructions

  • Ask your health care provider how your baby’s surgical site will be marked or identified.
  • To reduce your baby’s risk of infection:
    • Your baby may be given antibiotics to help prevent infection.
    • You may be asked to bathe your baby with a germ-killing soap.
  • Your baby may have an exam or testing.
  • Your baby may have a blood or urine sample taken.

What happens during the procedure?

  • To reduce your baby’s risk of infection:
    • Your baby’s health care team will wash or sanitize their hands.
    • Your skin will be washed with soap.
    • Hair may be removed from the surgical area.
  • An IV will be inserted into a vein. Fluids and medicine will flow through the tube.
  • Your baby will be given one or more of the following:
    • A medicine to help him or her relax (sedative).
    • A medicine to make him or her fall asleep (general anesthetic).
  • A small tube will be placed in your baby’s airway.
  • A small incision will be made in the upper part of your baby’s abdomen. Through this incision, the surgeon will find where the blockage is.
  • A new incision will be made in the intestine above and below the blockage.
  • The upper part of the intestine, which is above the blockage, will be attached with stitches (sutures) to the lower part of the intestine, which is below the blockage.
  • Your baby’s abdominal incision will be closed with sutures or skin adhesive, as needed.
  • The incision will be covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your baby’s blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines your baby was given have worn off.
  • X-rays will be taken to see if dye put through your baby’s NG tube will now pass through the intestine freely.
  • Sounds may be monitored in your baby’s abdomen by listening with a stethoscope. This means that air and fluid are passing through the lower digestive tract. These are called bowel sounds.
  • Feedings may be started after your baby has a bowel movement and bowel sounds and X-rays have shown air and fluid passing through the intestine normally.
  • The first feedings your baby will receive will be clear liquids only. When your baby is taking clear fluids well, full breast milk or formula feeding can be started as approved by your baby’s health care provider. This may take several days.

Summary

  • Intestinal atresia repair is a surgical procedure to repair blockage that can occur in various areas of the small intestine.
  • Generally, this is a safe procedure. However, some problems may occur, including future blockage from a surgical scar, as well as infection and bleeding.
  • After the procedure, your baby will be monitored, and tests will be carried out to make sure that the surgery was successful.

Care After Intestinal Atresia Repair in Newborn

Here is the information about how to care for your baby after the 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 your baby to have:

  • Swelling in the belly.
  • Gas.
  • Frequent spitting up.

Follow these instructions at home:

Incision care

  • Follow instructions from your baby’s health care provider about how to take care of the incision. Make sure you:
    • Wash your hands with soap and water before you change the bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Change your baby’s dressing as told by your baby’s 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, swelling, or pain.
    • Fluid or blood.
    • Warmth.
    • Pus or a bad smell.

General instructions

  • Give your baby over-the-counter and prescription medicines only as told by your baby’s health care provider.
  • If your baby was prescribed an antibiotic medicine, give it to him or her as told by the health care provider. Do not stop giving the antibiotic even if he or she starts to feel better.
  • Keep all follow-up visits as told by your baby’s health care provider. This is important. Your baby will need regular checkups to make sure he or she is getting enough nutrition and gaining weight.

Contact a health care provider if:

  • Your baby is not feeding well.
  • Your baby is not gaining weight.
  • Your baby vomits.
  • Your baby has a fever.

Get help right away if:

  • Your baby is not passing stool or urine.
  • Your baby’s stool is black or red.
  • Your baby is not feeding at all.
  • Your baby’s vomit is green or yellow.
  • Your baby who is younger than 3 months old has a temperature of 100°F (38°C) or higher.
  • Your baby’s stomach appears distended or tense.
  • Your baby’s skin or eyes appear yellow (jaundice).

Summary

  • After the procedure, it is common for your baby to have swelling and gas in the belly as well as frequent spitting up.
  • Follow instructions from your baby’s health care provider about how to take care of the incision, including changing your baby’s dressing and monitoring the area for infection.
  • Get help right away if your baby stops passing urine or stool, or if he or she is not feeding well or is jaundiced.
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