Congenital stenosis of the intestine refers to a condition where a part of an infant’s intestine is unusually narrow at birth. This narrowing, also known as a stricture, can partially obstruct the digestive tract. This means food and waste may have difficulty passing through. The condition originates during fetal development.
Understanding Congenital Intestinal Stenosis
Congenital intestinal stenosis describes a partial obstruction or narrowing within the intestine that is present from birth. The term “congenital” means it develops before birth, while “stenosis” refers to this incomplete blockage. This narrowing can occur in different sections of the small or large intestine, but it is most frequently observed in the duodenum, the first part of the small intestine connected to the stomach. Stenosis means the internal space, or lumen, of the intestine is significantly reduced, making it challenging for digested material to move through.
This condition differs from intestinal atresia, which involves a complete blockage or absence of an intestinal segment. While both are types of intestinal obstructions, stenosis allows some passage, whereas atresia causes a total stoppage.
Identifying the Signs
The presence of congenital intestinal stenosis often becomes apparent shortly after birth, though symptoms can vary based on the location and degree of the narrowing. One common sign is persistent vomiting, which can be bilious, appearing green or yellow. This type of vomiting signals that the obstruction is located beyond the stomach’s connection to the small intestine. Infants may also exhibit abdominal distension, where the belly appears swollen due to the buildup of gas and fluid above the narrowed segment.
Difficulty with feeding and an inability to gain weight are frequently observed. Affected newborns may fail to pass meconium, the first tar-like stool, or pass stools that are unusually small or mucus-like.
How It’s Diagnosed and Why It Happens
Diagnosis can sometimes begin before birth with prenatal ultrasound, which may reveal signs such as a dilated intestinal segment or excessive amniotic fluid. After birth, if symptoms suggest an obstruction, imaging techniques are employed. Abdominal X-rays can show dilated loops of bowel, indicating a blockage, and an upper gastrointestinal (GI) series or contrast studies can highlight the narrowed area.
The underlying reasons are generally related to issues during fetal development. A common theory suggests that an inadequate blood supply to a specific part of the intestine during gestation can lead to its improper formation or a failure of the intestinal lumen to fully open. In many instances, the exact cause remains unknown, but some cases are observed in conjunction with other congenital anomalies or genetic conditions, such as Down syndrome.
Approaches to Treatment and Recovery
Surgical intervention is the primary method for treating congenital intestinal stenosis. The goal is to open or remove the narrowed segment and reconnect healthy parts, restoring normal digestive function. Procedures such as a duodenoduodenostomy are performed when the narrowing is in the duodenum, involving the surgical joining of two parts to bypass the constricted area.
Before surgery, infants receive intravenous fluids for hydration and may have a tube inserted into their stomach to decompress it. After the procedure, careful monitoring, pain management, and a gradual reintroduction of feeding are necessary as the digestive system recovers. Most infants who undergo successful surgical repair recover well and can lead typical lives.