Skip to main content.

Intestinal Atresia (IA)

What is intestinal atresia?

Intestinal atresia (IA) means that part of your child's intestine didn't form completely. Instead of being an open tube, the intestine is closed off in one or more places. Some children are missing segments of the intestine between the closures. IA prevents food and stool (feces) from moving all the way through your child's body.

IA can range from a child having a small blockage to missing large segments of intestine. It can happen in the small intestine or less often in the large intestine. The cause of blockage in the first part of the small intestine (called the duodenum, pronounced due-ODD-en-um) is different from the cause in the other parts of the small intestine (called the jejunum, pronounced jeh-JUNE-um, and ileum, pronounced ILL-ee-um) or the large intestine. When the blockage is in the duodenum, there is also a greater possibility (about a 50% chance) of other problems in the other parts of the intestine.

Who gets intestinal atresia?

IA is present at birth (congenital). Duodenal atresia is due to a problem with the way the duodenum forms during development. Atresias in the other parts of the intestine usually result from loss of the blood supply at that specific segment of the intestine. There are various reasons why this might occur. About 1 in 2,500 babies has duodenal atresia, and 1 in 1,000 babies has jejunal or ileal atresia.

One sign of IA before birth is extra amniotic fluid (a condition called polyhydramnios and pronounced pahl-ee-hi-DRAM-nee-us). This occurs because the baby's intestines don't absorb the typical amount of fluid. Doctors can diagnose this through a prenatal ultrasound. It shows up as extra fluid around the baby inside the mother's womb.

What are the symptoms?

Your baby may have one or more of these symptoms within the first few hours or the first day or two after birth:

  • No stool passed
  • Swollen belly from gas
  • Vomiting, which may be yellow or greenish
  • Lack of desire to eat

How do you diagnose intestinal atresia?

If your baby has these symptoms, the doctor will want to take X-ray. Your baby may need a regular X-ray or a series of X-rays called a contrast study. For this your child may need to have a liquid put in their colon (enema) that shows up on X-ray film. Some babies will need the contrast dye placed in the stomach. The child will either be allowed to drink the contrast from a bottle or a small tube will placed into the stomach by the doctor.

Sometimes doctors suspect IA based on what they see during a routine ultrasound before your baby is born. This is most common with a duodenal atresia. If this happens with your baby, then your doctors can work with you before your baby is born to plan the treatment that will be needed after birth.

What is your experience with intestinal atresia at Children's?

We have treated many children with IA at Children's. Our surgeons are experienced at performing the surgery these children need to create an intestine that allows food and stool to pass so they can eat and thrive. We take care of approximately 20 to 30 babies each year with intestinal atresia.

When you come to Children's, you have a team of people to care for your child before, during and after surgery. Along with your child's surgeon, you are connected with doctors trained to care for new babies with complex problems (neonatologists), nurses, dietitians, child life specialists, social workers and others. We work together to meet all of your child's health needs and help your family through this experience.

Since 1907, Children's has been treating children only. Our team members are trained in their fields and also in meeting the unique needs of children. For example, the doctors who give your child anesthesia are board certified in pediatric anesthesiology. This means they have extra years of training in how to take care of kids. Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age. Our expertise in pediatrics truly makes a difference for our patients and families.

How do you treat intestinal atresia?

Surgery is the only treatment for IA. The first step is to stabilize your baby's health. Before surgery, your baby will have a tube inserted that passes through his or her nose or mouth into the stomach to empty it and keep gas out (called a nasogastric tube, NG tube, or orogastric tube, OG tube). Your baby will also need an IV (short for intravenous) line, a tube that goes into a vein to replace fluids lost while vomiting or unable to eat.

Surgery

At the time of surgery, your child will have general anesthesia. This means we will give your child medicine to make them sleep without pain during the surgery. The surgeon will make a cut, or incision, in your child's abdomen and examine the intestines to find the part that is blocked. Then the surgeon will cut on both sides of the blocked sections and create openings that can be sewn together so the intestine becomes an open tube. Sometimes the surgeon may have to remove parts of the intestine to correct the problem. Once the blockage is repaired, the surgeon will close the incision in the skin. Some babies may need a feeding tube, called a gastrostomy (pronounced gas-STRAH-stuh-mee) tube (G tube), placed at the time of this surgery, if doctors expect the baby to have feeding problems. (See below.)

The length of the surgery can vary, depending on exactly what your child needs. Before surgery, the surgeon can give you an estimate of how long your child's surgery will take. Most of these children are in the intensive care unit (ICU) when they are admitted to Children's. After surgery they will either go directly back to the ICU or to the recovery room depending on their condition.

Gastrostomy

Some children need a gastrostomy placed into their stomach so they can receive nutrients this way. Your surgeon can discuss this with you if your child might need it. To place a gastrostomy, the surgeon makes an opening through the wall of your child's abdomen and places a tube or a device called a gastrostomy button. This provides a safe way to give your child nutrition (and medicine, if needed) until they can feed by mouth. You will be taught how to take care of the tube or button and the skin around it, and how to feed your child through the gastrostomy, if your child needs this.

After surgery

After surgery, we will give your child pain medicine to make them comfortable. They will have an NG or OG tube and will get fluids and antibiotics through an IV.

You can expect your child to stay in the hospital for at least a couple of weeks. If there are no other birth defects or complications, the stay will likely be two to four weeks. Some children will take considerably longer to recover, especially if there are other problems.

For some types of atresia, it may be several weeks or longer for the intestine to recover enough that the baby can eat by mouth. Until that time the baby will be fed through a special IV called a PICC line, a G-tube or more likely both. The surgery team will be able to give you an idea of the time frame and what to expect with feeding issues.

By the time you go home there is usually little that needs to be done with the incision. It is usually well healed, and there are no restrictions on activity or bathing.

About one to three weeks after going home from the hospital, your child will need to see the surgeon for a follow-up visit. The surgeon will make sure your baby is gaining weight and growing well, and there are no other issues. Our dietitians are usually involved with this visit.

Resources

Read more about what to expect when your child visits a clinic at Children's, has surgery here or needs to stay in the hospital. You can get practical details about topics like what to do and bring the day of surgery and who will be on your child's care team. You can also take a virtual tour of our surgery rooms and other parts of the hospital.

To learn more about this condition, you may want to visit our resource list.