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An apple-peel intestinal atresia is a rare form of bowel atresia. Herein, reported a case of apple-peel intestinal atresia that was treated with a diamond-shaped anastomosis to adjust the anastomosis size. A female infant was born at 33 weeks of gestation with a birth weight of 1936 g. The prenatal ultrasound revealed proximal intestinal dilatation and polyhydramnios. She had a prenatal diagnosis of suspected congenital jejunal atresia. Post-natal abdominal X-ray showed triple bubble sign with the paucity of gas in the lower bowel, as well as concerned proximal bowel obstruction. She underwent surgical repair for jejunal atresia at 2 days of age. Surgical exploration revealed a markedly distended atretic jejunum with apple-peel jejunal atresia and a significant loss of intestinal length. A difference in the diameter of approximately 3: 1 was found between the oral and the anal intestine, and the end-to-end anastomosis was difficult. Therefore, a diamond-shaped anastomosis was performed using 5-0 polyglycolic acid sutures by incising the dilated oral tract in the minor axis and the anal in the major axis. A trans-anastomotic tube was placed nasally beyond the anastomotic site. The postoperative course was uneventful. Therefore, the diamond-shaped anastomosis may be an option for apple-peel intestinal atresia.

There are different strategies for the treatment of long gap esophageal atresia (LEA), but many aspects of its management is still controversial. The best treatment is conserving the native esophagus through the connection of two esophageal pouches. In this study, we shared our experiences in management of LEA treatment and introduced a new approch for the conservative management of this condition.In our experience, ten patients with long gap esophageal atresia were treated, followed up and managed by our own designed method. In our technique, we lengthened the both upper and lower pouches instead of one pouches. On the one hand, with the effect of saliva pressure, the upper pouch became longer without proximal esophagostomy. On the other hand, the lower pouch was mechanically lengthened by the feeding effect of gavage. These reduced the distance between the two ends of the esophagus and provided the conditions for the primary anastomosis and saving the native esophagus. There were no complication in these ten patients but this procedure needs more investigation.

An apple-peel intestinal atresia is a rare form of bowel atresia. Herein, reported a case of apple-peel intestinal atresia that was treated with a diamond-shaped anastomosis to adjust the anastomosis size. A female infant was born at 33 weeks of gestation with a birth weight of 1936 g. The prenatal ultrasound revealed proximal intestinal dilatation and polyhydramnios. She had a prenatal diagnosis of suspected congenital jejunal atresia. Post-natal abdominal X-ray showed triple bubble sign with the paucity of gas in the lower bowel, as well as concerned proximal bowel obstruction. She underwent surgical repair for jejunal atresia at 2 days of age. Surgical exploration revealed a markedly distended atretic jejunum with apple-peel jejunal atresia and a significant loss of intestinal length. A difference in the diameter of approximately 3: 1 was found between the oral and the anal intestine, and the end-to-end anastomosis was difficult. Therefore, a diamond-shaped anastomosis was performed using 5-0 polyglycolic acid sutures by incising the dilated oral tract in the minor axis and the anal in the major axis. A trans-anastomotic tube was placed nasally beyond the anastomotic site. The postoperative course was uneventful. Therefore, the diamond-shaped anastomosis may be an option for apple-peel intestinal atresia. • Apple-peel intestinal atresia is a rare form of bowel atresia that affects approximately 1/50000 live births. • In recent years, primary anastomosis with proximal enteroplasty has been successfully performed in patients with apple-peel type congenital small intestinal atresia. • We report a case of apple-peel intestinal atresia that was treated with a diamond-shaped anastomosis to adjust the anastomosis size. • The diamond-shaped anastomosis may be an option for apple-peel intestinal atresia. [ABSTRACT FROM AUTHOR]

There are different strategies for the treatment of long gap esophageal atresia (LEA), but many aspects of its management is still controversial. The best treatment is conserving the native esophagus through the connection of two esophageal pouches. In this study, we shared our experiences in management of LEA treatment and introduced a new approch for the conservative management of this condition. In our experience, ten patients with long gap esophageal atresia were treated, followed up and managed by our own designed method. In our technique, we lengthened the both upper and lower pouches instead of one pouches. On the one hand, with the effect of saliva pressure, the upper pouch became longer without proximal esophagostomy. On the other hand, the lower pouch was mechanically lengthened by the feeding effect of gavage. These reduced the distance between the two ends of the esophagus and provided the conditions for the primary anastomosis and saving the native esophagus. There were no complication in these ten patients but this procedure needs more investigation. [ABSTRACT FROM AUTHOR]