Apple peel atresia: a case report

A 3 days old child presented with chief complaints of bilious vomiting and abdominal distention since few hours duration. Prenatal history revealed mother to be polyhydraminos and pregnancy induced hypertensive was on treatment with labetolol. Baby was a term, emergency lscs delivery. On examination baby was active, alert and with fair hydration. On per abdominal examination abdomen was distended and dilated bowel loops were seen. On per rectal wash pale jelly stools were expelled. Baby was taken up for emergency laprotomy and found to be having illeal atresia for which resection and anastamosis is done. Post operatively baby was doing well with satisfactory weight gain. Intestinal atresias are the major cause of intestinal obstruction in cases of neonates. They may be illeal or duodenal atresia. It is hypothesized to be occurring due intrauterine vascular assault and failure of recanalization. Babies present with vomiting and abdominal distention with mother having a positive history of polyhydraminos. On examination there will be abdominal distention with dilated bowel loops. X-rays would show dilated bowel loops and ultrasound shows decreased peristalisis in the bowel loops. Emergency laprotomy and surgical resection is the treatment of choice.

Anorectal malformation with apple peel atresia: case report of a rare association

Anorectal malformations (ARM) are common congenital malformations. They are mostly associated with other congenital anomalies including but not limited to vertebral anomalies, cardiac malformations, Tracheoesophageal fistula, esophageal atresia, Renal anomalies, limb anomalies and aneuploidy (Trisomy 21). Apple-peel atresia or ‘Christmas-tree deformity’ consists of a high jejunal atresia with discontinuity of the small bowel and a wide gap in the mesentery. Association of Apple peel atresia with ARM has been reported by many authors in past and in any neonate presenting with ARM proximal atresia needs to be ruled out before surgical intervention is undertaken and newborns with ARM and presenting with drooling of saliva, bilious or non-bilious vomiting in presence of non-distended abdomen must give rise to a suspicion of associated atresia. We are reporting this case of high anal atresia with apple peel atresia of terminal ileum who was treated by double barrel ileostom to emphasize the importance of knowing this association.

Duodenal Atresia Associated with Apple Peel Atresia and Situs Inversus Abdominus: A Case Report

Duodenal atresia is rarely associated with situs inversus abdominus. We report a case of duodenal atresia associated with small bowel atresia of apple peel type and situs inversus abdominus.