pediatrics
Overview of Congenital Gastrointestinal Anomalies
Introduction
Most congenital gastrointestinal (GI) anomalies present as intestinal obstruction and frequently manifest as feeding difficulties, distention, emesis, and an inability to pass gas and stool at birth or within 1 or 2 days of age. Some congenital GI malformations, such as Malrotation of the Bowel , have a very good outcome, whereas others, such as congenital A common type of anomaly is atresia, in which a segment of the GI tract fails to form or develop normally or it forms and then is destroyed by an intrauterine event, such as a vascular disruption. The most common type is Esophageal Atresia , followed by Immediate management includes bowel decompression (by continuous nasogastric suction to prevent emesis, which can lead to aspiration pneumonia or further abdominal distention with respiratory compromise) and referral to a center for neonatal surgery. Also vital are maintenance of body temperature, prevention of hypoglycemia and dehydration with IV fluids containing 10%dextroseand electrolytes, and prevention or treatment of acidosis and infections so that the infant is in optimal condition for surgery. Because approximately one third of infants with a GI malformation may have another congenital anomaly (eg, up to 50% in those with congenital diaphragmatic hernia and up to 70% in those with Omphalocele ), they should be evaluated for malformations of other organ systems, especially of the central nervous system, heart, and kidneys. 