Acquired intestinal atresia secondary to postoperative adhesions in a 7-month-infant: A case report

Acquired intestinal atresia is a very rare condition defined as complete luminal occlusion and absence of a previously patent section of the bowel. Most reported cases are related to strictures after necrotizing enterocolitis, whereas cases related to other conditions are extremely rare. A 7-month-old girl presented with bilious vomiting and abdominal distension for 1 day. She was born at 24 weeks of gestation with a weight of 640 g. At 18 days of life, she underwent a small bowel segmental resection and end ileostomy for spontaneous small bowel perforation. After 60 days, the ileostomy was closed. Abdominal radiography revealed small bowel dilatation and abdominal computed tomography revealed dilated proximal small bowel loops and collapsed distal small bowel loops. A small bowel obstruction secondary to adhesive bands was suspected. The obstruction did not improve after conservative management for 4 days, which included nil per os and decompression via nasogastric tube, so the patient was taken to the operating room for a surgical exploration. The site of the obstruction was completely atretic due to compression from an adhesive band. there was also a V-shaped mesenteric defect under the site of the atresia. We resected the atretic segment and did an end-to-end anastomosis. She was discharged 7 days after the operation without complications. One year later, she was seen in the outpatient clinic and was growing normally without any digestive issues. Acquired intestinal atresia should be included in the differential diagnosis of infants who had previous abdominal operations and present with an intestinal obstruction.