Abstract
Intestinal obstruction in newborn infants is caused by a variety of congenital anomolies and leads to the death of the infant within the first week of life if not treated surgically. The causes of such intestinal obstructions may be an atresia of the oesophagus ,a diaphragmatic hernia, an annular
pancreas, malrotation of the colon with volvulus of the midgut, peritoneal bands mostly compressing the duodenum, internal or mesentericoparietal herniations, muconium ileus, agauglionic megacolon, atresia of the bowel and imperforate anus. Of all these a short summary of the first and last causes will be given. Congenital atresia of the oesophagus and tracheooesophageal fistual are among the most common anamolies encounter ed .
in the newborn infant. In the great majority of anomilies, the upper portion of the oesophagus ends as a blind pouch at the level of the second thoracic vertebra, and the lower segment of the oesophagus enters the trachea just below its bifurcation. The symptoms are noted soon after birth, and the patient seems to produce an excessive amount of saliva accompanied by spells of choking and cyanosis, which increase with the attempts to feed the infant. Roentgen examination will establish the diagnosis. The exact location of the obstruction may be determined by introducing a" rubber catheter under fluoroscopic control; and may be visualized by instillation of an appropriate contrast medium. Pediatricians and obstetricians must be alerted to these anomolies because symptoms will be observed soon after birth. The patient should be kept in the incubator which provides for an influx of oxygen ( cont ), controlled temperature and humidity. A soft rubber catheter should be introduced into the pharynx for constant suction. Slight Trendelen burg position will facilitate aspiration of the mucus. Intravenous feeding of a 5 per cent solution of dextrose in distilled water is mandatory to maintain or restore the infants' nutritional status, so that an operation, the only rational treatment, may be performed at the earliest possible moment.