Factors affecting survival of life and health related quality of life in patients with small bowel atresia and stenosis

Purpose: In this study we aimed to investigate the causes of morbidity and mortality and the factors that influence survival in life and growth in patients followed up with small bowel atresia/stenosis. Patients and method: 85 patients included to this study that admitted to our clinic with small bowel atresia/stenosis or followed up with duodenal, proximal jejunoileal, distal jejunoileal atresia/stenosis between 2002-2012. Data on patients gender, prenatal diagnosis, time of diagnosis, time of birth, birth weight, maternal age, level of parental consanguinity, clinical features, associated anomalies, peroperative findings, postoperative hospitalisation, duration of total parenteral nutrition, period to enteral feeding, time of full dose oral feding recorded and factors affecting morbidity and mortality and growth parameters analysed. Results: 85 patient were included in this study, 44 female and 41 were male. 35 of these patients were duodenal, 29 proximal jejunoileal, 21 distal jejunoileal atresia/stenosis. 58% of the patients was premature and the rate of prematurity was more at patients with duodenal atresia/stenosis. Kinship between parents was high in patients with distal jejunoileal atresia/stenosis. 54% of the patients was diagnosed by prenatal ultrasound. Additional congenital anomaly have seen at 64% of patients with duodenal atresia/stenosis and 58% of jejunoileal atresia/stenosis. Most common additional anomaly of patients with duodenal atresia/stenosis was congenital hearth disease and Down Syndrome respectively. Duodenoduodenostomy was most common used method of operation for duodenal atresia and resection and primary anastomosis for jejunoileal atresias. Mortality rate was 18%. Overall complication rate was 20% in all groups and most common complication was sepsis. Most common cause of death was sepsis and in these patients rate of prematurity, low birth weight and additional congenital anomaly was higher. Patients were examined in terms of growth and developement, in duodenal atresia/stenosis group body weight and persantiles were normal, in jejunoileal atresia group persantiles of length was lower. Conclusion: In patients with small bowel atresia/stenosis rate of mortality was higher according to rates in the literature. Prematurity, low birth weight and additional congenital anomalies was higher in patients who died, so surgical complications did not intended as a primer. Appearance of very low rates of late-term complications could be related to the high mortality rate. In patients with jejunoileal atresia/stenosis, persantiles of body weight was lower and we recommend close follow-up of patients for diet and malabsorbtion in postoperative period. Key words: Duodenal atresia, stenosis, atresia jeunoileal, mortality, quality of life