Intrauterine intussusception as cause of small bowel atresia - Report of series of rare clinical cases

Intestinal invagination is a disease that is most commonly found in children from 3 months to 3 years old. Invagination has also been described as the intrauterine cause of intestinal atresia. Objective of the research: to demonstrate 3 clinical cases when intrauterine invagination caused congenital intestinal obstruction of the small intestine. The study describes the experience of surgical treatment of 3 patients with atresia of the small intestine type I and type IIIA due to intussusception that occurred during the prenatal period. Two patients underwent intestinal anastomosis using laparotomy. In one patient, the intestinal anastomosis was performed in a laparoscopic manner. The early and long-term results of operations are investigated. Successful surgical treatment of atresia of the small intestine due to intrauterine invagination was possible in all 3 patients. Two patients had type IIIA atresia (separation of segments with a V-shaped defect of the mesentery), one - type I (membranous form) of this anomaly. The gender composition of the patients is represented by 2 girls and 1 boy. The weight of patients was in the range of 1280-2800 grams. Surgical treatment for all patients was performed on the 2nd day of life. The duration of the operation ranged from 60 to 65 minutes. Start enteral nutrition was possible in the range from 2 to 3 days after surgery. Full enteral nutrition is restored within 5 to 8 days after surgery. In the early follow up period after surgery, there were no signs of failure of the anastomosis. During the observation of patients from 6 months to 1 year, there were no signs of impaired intestinal transit. Intrauterine invagination is a rare cause of intestinal atresia. This disease has a good prognosis provided timely intervention and the absence of associated abnormalities. Laparoscopy in an expert children’s surgical center can be an alternative in the treatment of patients with jejuno-ileal atresia caused by intrauterine invagination.