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Congenital Abnormalities of the Small Intestine
Congenital lesions develop in the gastrointestinal (GI) tract and may cause intestinal obstruction ( Fig. 55.1 ). Almost all presentations are in newborns and necessitate immediate surgery. The most common site of complete obstruction or atresia (congenital absence or closure) is in the ileum. The duodenum is the second most common site. Obstruction may result from atresia, malrotation of the colon, volvulus, meconium ileus, or imperforate anus.
Congenital Intestinal Abnormalities, Including Malrotation of the Colon With Volvulus of the Midgut.
Clinical Picture
Vomiting, absence of stool, and abdominal distention are the clinical triad indicating a significant problem in an infant. Certain atresias are evident within the first 24 hours. Malrotation, volvulus, and meconium ileus may manifest immediately. An infant with an imperforate anus produces no stool; diagnosis should be made on initial examination of the newborn.
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