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Jejunal atresia and unilateral postaxial polydactyly: second report of a rare association.

Introduction A female baby was born by spontaneous vaginal delivery at home to a 33-year-old, G6P5-6 mother at 38 weeks of gestation. The pregnancy was complicated by poorly controlled, type 2 diabetes, methamphetamine use, and lack of prenatal care. Birth weight was 3300 g (56th percentile). Shortly after arriving at the hospital, the baby developed copious bilious emesis. An abdominal ultrasound showed dilatation of the proximal small bowel, consistent with proximal jejunal atresia. An upper gastrointestinal (GI) series showed filling of the proximal duodenum with air and contrast, with an abrupt interruption to the left of the spine and no contrast distally, consistent with distal duodenal or proximal jejunal atresia (Fig. 1a). An exploratory laparotomy showed a type 1 (web) atresia near the ligament of Treitz in the proximal jejunum. The baby underwent an uncomplicated, open proximal jejunal web resection through longitudinal enterotomy on the third day of life. There was no microcolon or malrotation.