The etiologic role of intrauterine volvulus and intussusception in jejunoileal atresia.
OBJECTIVE
Although intussusception has been reported as quite a rare cause of jejunoileal atresia (JIA), pediatric surgeons have noted the frequent presence of intussusception as well as volvulus at surgery. The aim of this study was to investigate the contribution of intrauterine intussusception and volvulus to the development of JIA.


METHODS
In 48 newborns (24 boys and 24 girls) treated for JIA at our hospital between 1978 and 2004, the operative and pathologic findings were reviewed.


RESULTS
Intussusception was responsible for gap and cord type atresia in 12 cases (25%). The cord showed an atrophic intestinal lumen in 2 cases. Volvulus was observed in 13 cases. Volvulus and intussusception were simultaneously noted in 1 case. This suggested that intussusception was the cause of the atresia, whereas volvulus was a secondary event. Neither intussusception nor volvulus was observed in high jejunal, apple peel, or multiple atresia.


CONCLUSIONS
Intrauterine volvulus and intussusception were commonly observed in single mid- and low JIA. Thus, intrauterine intussusception may be a common cause of gap and cord type JIA. Volvulus may not only cause JIA but also result from anatomic changes after the development of JIA in some cases.
Komuro
Hiroaki
H
Department of Pediatric Surgery, Institute of Clinical Medicine, University of Tsukuba, Tennodai, Ibaraki 305-8575, Japan.
Hori
Tetsuo
T
Amagai
Teruyoshi
T
Hirai
Misako
M
Yotsumoto
Katsumi
K
Urita
Yasuhisa
Y
Gotoh
Chikashi
C
Kaneko
Michio
M
D005260:Female; D005315:Fetal Diseases; D006801:Humans; D007077:Ileal Diseases / Q000150:complications*; D007082:Ileum / Q000002:abnormalities*; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000209:etiology*; D045822:Intestinal Volvulus / Q000150:complications*; D007443:Intussusception / Q000150:complications*; D007579:Jejunal Diseases / Q000150:complications*; D007583:Jejunum / Q000002:abnormalities*; D008297:Male