Jejunal atresia in a twin gestation

Fabrice Cuillier, MD Michel J.L, MD

Dept of Obstetrics and Gynecology, HĂ´pital FĂŠlix Guyon, rue des Topazes, 97400 Saint-Denis, Reunion Island, France. Ph : 0262 90 55 22.

This is a twin gestation in a woman who had undergone in-vitro fertilization. This was her first pregnancy. The first and second ultrasound examinations were normal. At 30 weeks of gestation, one of the twins demonstrated abnormal echogenic bowel loops. The stomach was normal and there was evidence of polyhydramnios. Several fluid distended bowel loops were noted and the distention of the loops progressed gradually.

Scan at 30 weeks: Stomach on the right side and distended bowel loops on the left side are noted.

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Scan at 33 weeks: Progression of the distention of the bowel loops is noted.

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Based on the above findings, a prenatal diagnosis of jejunal atresia was suspected. The twins were delivered by a ceaseran section at 33 weeks of gestation. Postnatal surgery was performed on day 3 in the twin suspected of having atresia of the jejunum. Atretic segments at 21 different places were identified and end-to-end anatsomosis at 5 different places were performed.   

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The baby received parenteral nutrition up to day 21. She was seen again on day 60 and showed no signs of malnutrition and was growing normally.

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