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Case Report

RMJ. 2016; 41(4): 514-515


Primary end-to-oblique anastomosis after partial closure of the dilated proximal bowel in type IIIa ileal atresia: a case report

Ki Hoon Kim, Jin Soo Kim, Woon-Won Kim, Mi Lim Chung, Jimi Jung, Yong Han Kim, Yun-Jung Lim.

Abstract
Intestinal atresia is one of the most frequent causes of bowel obstruction in infants and can occur at any point within the gastrointestinal tract. We report a case of type IIIa ileal atresia in which the patient underwent end-to-oblique anastomosis after partial closure of the dilated proximal bowel to match the diameter of the distal bowel. A 3-day old male baby born at a gestational age of 39 weeks with sudden-onset bilious vomiting underwent laparotomy under a presumed diagnosis of ileal atresia. Type IIIa ileal atresia was located approximately 20 cm from the ileocecal valve, and approximately 20 cm of the proximal dilated bowel was resected. However, primary anastomosis could not be performed because of differences in the diameters of the proximal and distal bowels. Hence, the proximal intestine was partially closed to reduce its diameter, after which end-to-oblique anastomosis was performed. Anastomotic complications such as leakage and passage problem were not seen postoperatively.

Key words: Intestinal atresia; End-to-oblique anastomosis; Ileal atresia; Primary anastomosis



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