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Diagnosing Ileal Atresia: The Role of Clinical Correlation and Plain Radiography

Timothy Mwai Jumbi1, Manvinder Singh Mann1, Joel Kipyegon Lessan2

1. University of Nairobi

2. Kenyatta National Hospital

Correspondence to: Dr. Timothy Jumbi, University of Nairobi P.O Box 1059- 00618 Nairobi, Kenya.

Email:mwaitim@gmail.com

Summary

Ileal atresia is a subset of congenital gastrointestinal malformations that result in neonatal bowel obstruction. We report a case of a 7-day old male neonate who presented with failure to pass meconium, abdominal distension and late onset bilious vomiting. A plain abdominal radiograph revealed dilated bowel loops with fluid levels of different sizes, the largest appearing as a fluid filled mass with an abrupt cut off. These findings were consistent with ileal atresia and the diagnosis was confirmed intra-operatively. This case description is aimed at emphasizing the role of clinical correlation and a plain abdominal radiograph in the diagnosis of ileal atresia which are two important modalities that have imaging modalities which delay management. The diagnosis of ileal atresia can be suspected in the neonate who presents with failure to pass meconium, abdominal distension,  late  onset  bilious  vomiting  and  a  plain abdominal  radiograph  with  fluid  levels  of  different sizes, the largest situated just proximal to the atretic zone.

Key words: Ileal atresia, plain radiograph, clinical assessment

Ann Afr Surg. 2018;15(2):73-76

DOI:http://dx.doi.org/10.4314/aas.v15i2.9

© 2018 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

Conflicts of Interest: None

Funding: None

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