From the Research
Intestinal atresias are primarily classified into five main types, with duodenal atresia being the most common, followed by jejunal, ileal, and mixed atresias, as reported in the most recent study 1. The classification of intestinal atresias is crucial for surgical planning and prognosis. The five main types are:
- Type I: mucosal/submucosal web with intact mesentery and serosa
- Type II: two blind ends connected by a fibrous cord with an intact mesentery
- Type IIIa: disconnected blind ends with a V-shaped mesenteric defect
- Type IIIb: large mesenteric defect with the distal bowel spiraling around a single blood vessel (apple-peel or Christmas tree atresia)
- Type IV: multiple atresias giving a "string of sausages" appearance The etiology of intestinal atresias is primarily related to intrauterine vascular accidents leading to ischemia and resorption of affected bowel segments, as discussed in 2. Duodenal atresias, which occur proximal to the ampulla of Vater, are often associated with Down syndrome and typically result from failure of recanalization during embryonic development rather than vascular events, as noted in 1 and 2. Prompt surgical intervention is necessary for all types, with the specific approach determined by the atresia type and location, as emphasized in 1 and 3. The most recent study 1 provides the most up-to-date information on the classification, epidemiology, and surgical management of intestinal atresias, and its findings should be prioritized in clinical decision-making. Key points to consider in the management of intestinal atresias include:
- Associated anomalies, such as malrotation, which can impact surgical planning and outcomes, as discussed in 1 and 4
- The need for careful investigation of bowel continuity to avoid missing associated intestinal atresias, as highlighted in 3
- The importance of prompt surgical intervention to prevent complications and improve outcomes, as emphasized in 1 and 2