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Fetopathology and developmental pathology of the embryo and fetus
Marta Ježová, Josef Feit et al.
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Atresia
Classification

Several morphologic types:

  • type I: membranous: the intestine is closed by a diaphragm formed of connective tissue
  • type II: disrupted continuity of the intestine, segments are connected by a fibrous band
  • type III: disrupted continuity of the intestine, a gap between the segments
  • type IV: multiple atresias
Clinical signs
  • vomiting
  • dilatation of the intestine
  • disorder of the meconium passage
Macroscopic appearance
  • atresia (mainly type I and II) or stenosis in the duodenum is more frequent than defects of other parts of the intestine and is often associated with various anomalies such as intestinal malrotation, annual pancreas, congenital volvulus, Ladd's syndrome (fibrous bands), tracheoesophageal fistula and others
    • has characteristic macroscopic appearance of hour glass (“double bubble”)
    • prenatally polyhydramnion is present
    • postnatally explosive vomitting
  • jejunoileal atresia (all types) is less frequently associated with other malformations
    • proximal section of the intestine is conspicuously dilated
    • perforation may complicate the condition of the patient
    • the part behind the stenosis is contracted with narrow lumen
  • atresia of the colon forms only 10% of the intestinal atresias; majority affects the intestine proximally from the lineal flexura
Pictures

Duodenal atresia: Duodenal atresia, Macro, autopsy (73044)