Congenital stenosis and atresia of the jejunum and ileum.

The macroscopic and microscopic findings in 12 cases of stenosis and/or atresia of the jejunum and ileum are presented. There was considerable uniformity within the series with overlapping of cases of atresia, stenosis, and gut infarction. An analysis of associated lesions in cases coming to necropsy suggests that the infants were suffering from shock. In nine out of the 12 cases there was evidence of intrapartum asphyxia and in eight cases evidence of retardation of intrauterine growth. It is argued that, since many of the associated complications of pregnancy are known to be of importance in the aetiology of gut infarction in the neonatal period, they are likely to be of aetiological significance in the development of atresia and stenosis of the gut. A review of perinatal deaths shows that gut ischaemia of varying degrees of severity is a common finding at necropsy, being noted in 19 out of 56 cases studied. It is suggested that stenosis and atresia are sequelae of previous gut ischaemia.