J.Jpn. Surg. Soc.. 80(11): 1289-1293, 1979

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Report on the annual meeting

PATHOGENESIS AND MANAGEMENT OF INTESTINAL ATRESIA AND GASTOSCHISIS

1. Experimental study was carried out using fetal puppy and rabbit to investigate the pathogenesis of intestinal atresia. In rabbit, type I, II and III intestinal atresia were produced by between the 6th and 9th postoperative day following ligation of mesenteric vessels. Histopathological findings revealed that firstly necrosis and coagulation of the mucosa and submucosal layer of the affected segment were occured, then this necrotic mucosa was replaced by granulation tissues around the normal healthy tissues.
2. 17 of the 19 patients (89%) with jejunoileal atresia are surviving, while only I7 of the 33 patients (52%) with duodenal and high jejunal atresia are surviving. These patients showed high incidence (65%) of additional gross variant of anomalies and short gut syndrome.
3. The patients with gastroschisis easily develop thickning of protruded intestine, decreased body temperature, metabolic acidosis and infection. Therefore the most important and difficult problem is to prevent these complications during pre-and postoperative management. Recently, the surviving rate is increasing with establishment of early surgical repair and improvement of respiratory management. Four of our recent cases with gastroschisis are all surviving.

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