Total intestinal atresia challenges the limits of neonatal surgery and healthcare equity in resource limited settings

Résumé fourni par la source

Total intestinal atresia (TIA) is an exceptionally rare and severe form of neonatal intestinal obstruction, characterized by near-complete absence of functional bowel. Unlike more common types of intestinal atresia, which are amenable to surgical correction, TIA represents a fundamentally different condition in which curative surgery is not feasible. This commentary highlights the clinical, diagnostic, and systemic challenges associated with TIA, drawing on a recent case and existing literature. Clinically, TIA presents similarly to other forms of intestinal atresia, with or without bilious vomiting, minimal abdominal distension though it depends on the level of obstruction, and failure to pass meconium. However, current prenatal and postnatal imaging techniques are unable to determine the full extent of bowel involvement, and diagnosis is typically made intraoperative. This limitation complicates preoperative counseling and surgical planning. The pathogenesis of TIA remains unclear; conventional theories, such as failure of recanalization or intrauterine vascular insults, do not adequately explain the diffuse nature of the condition. To date management is largely supportive, as definitive surgical treatment is not possible. Total intestinal atresia is an exceptionally rare congenital anomaly with an almost uniformly fatal prognosis. Even in well-resourced settings, survival is exceedingly rare despite advanced nutritional and surgical support, while in resource-limited settings the condition is effectively fatal due to the lack of total parenteral nutrition and intestinal transplantation. This condition highlights major diagnostic, therapeutic, and global health equity challenges, underscoring the need for further research and improved access to specialized neonatal care.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.