Authors: Mathayo Shadrack , Mohammed Sultan Salim , Evelyne Neema Assenga , Ally Hamisi Mwanga , Victor Ngotta , Zaitun Bokhary

Abstract

Background: Jejunoileal atresia (JIA) is a leading cause of neonatal intestinal obstruction. Despite advances in neonatal surgery, mortality remains high in resource-limited settings due to delayed presentation, sepsis, and limited perioperative support. We report seven consecutive neonates with JIA managed at our hospital, highlighting diagnostic findings, anatomical variations, surgical approaches, and early outcomes.

Methods: This combined retrospective and prospective descriptive study included seven consecutive neonates admitted with intestinal obstruction between October 2024 and October 2025. Diagnosis was based on clinical evaluation, plain abdominal radiography, and ultrasonography. All underwent open laparotomy via a supra-umbilical transverse incision. Primary end-to-oblique single-layer hand-sewn anastomosis was performed in six cases. One required staged management with resection, double-barrel stoma formation, subsequent anastomosis, and correction of malrotation. Outcomes were analyzed, including follow-up to six weeks post-discharge.

Results: Seven neonates were included (median birth weight 2.9 kg; median age 3 days). Two had jejunal atresia type I (28.6%), three ileal type IIIB (42.8%), and two type IIIA (28.6%). All presented within 2–4 days with bilious vomiting, abdominal distension, and failure to pass meconium. Median time to full enteral feeding was 5 days (range 4–7). Mean NICU stay was 7 days. Two developed superficial surgical site infections managed conservatively. No leaks, sepsis, reoperations, or mortality occurred. Median hospital stay was 9 days (range 7–15).

Conclusion: Early diagnosis, optimization, and meticulous surgical technique enabled excellent outcomes in this resource-limited setting, demonstrating safe and effective management of jejunoileal atresia in neonates with consistent multidisciplinary perioperative care.

Keywords: Jejunoileal atresia, neonatal intestinal obstruction, apple-peel deformity, surgical outcomes.