Atretic midgut; a rare congenital cause of short bowel syndrome: Case report from Ethiopia

Abstract

Background: Neonatal short bowel syndrome is a devastating condition that carries a high mortality in the developing world. Among the congenital causes of this condition is midgut atresia which is exceedingly rare and often associated with gastroschisis. Case presentation: 7days old male neonate born to 34 yrs old Para II mother who had uneventful antenatal follow up at gestational age of 32+6 weeks with a birth weight of 1600 gm. He presented with bilious vomiting and abdominal examination revealed no evidence of abdominal wall defect. Abdominal x-ray showed triple bubble appearance. After resuscitation he was explored with a finding of atretic midgut located between blindly ending duodenum and distal third of the transverse colon for which duodeno transverse anastomosis was done and he was put on progressive oral feeding postoperatively despite which he passed away after developing several complications of short bowel syndrome. Conclusion: This case report represents a rare congenital cause of neonatal short bowel. The outcome of such neonates in the absence of bowel lengthening procedures, parenteral nutrition and intestinal rehabilitation centers is expected to be dismal in the developing countries emphasizing the importance of proper prenatal counseling.

Keywords

• Short bowel syndrome
• Midgut
• Atresia
• Gastroschisis
• Ethiopia