What is small bowel atresia?: An ERNICA animation for parents and families

This animation aims to provide you with more information about small bowel atresia. The small intestine is a muscular tube connecting the stomach and a part of the large intestine called the colon. When you eat, food enters and passes through your stomach into the small intestine. Food and fluid are transported through the small intestine, and nutrients needed for growth and development are absorbed into the blood. To transport the food and fluid, the small intestine must move in a certain way. This type of movement is called peristalsis. Sometimes a baby's small intestine does not develop properly during pregnancy, and a segment or multiple segments are abnormally narrow or missing completely. This absence or abnormal narrowing is known as small bowel atresia or small intestinal atresia, and it is classed as a rare birth defect. Small bowel atresia blocks the normal transportation of fluid and food through the small intestine. The part of the small intestine above the affected area will expand due to a buildup of fluid and food. In most cases, the cause of small bowel atresia is unknown. It is thought that it may occur because of reduced blood flow to a part of the intestine during pregnancy. In some cases, it may be associated with other birth defects, such as cystic fibrosis. Small bowel atresia may be suspected before birth using ultrasound, which is a way of obtaining images of your baby in the womb. A diagnosis can be confirmed in the hours after birth using an imaging technique called an X-ray. Babies that do not pass meconium or present with repeated vomiting and swelling of the belly in the first few days of life must undergo an X-ray or more than one X-ray if needed. Your baby's ongoing care should be provided at a specialist center by a dedicated team of professionals who have knowledge and experience of looking after babies with small bowel atresia. Early detection of small bowel atresia is very important. If it is not treated, a child will not be able to feed, which is necessary for survival and growth. Once a diagnosis is confirmed, surgery can be planned. Before surgery takes place, dehydration and any other health concerns should be managed. A baby's stomach may also be emptied using a special tube passed down through the nose to prevent contents of the stomach from flowing into the lungs during surgery. Surgery for small bowel atresia aims to create an unobstructed passage through the small intestine for food and fluid to travel. Narrow segments are removed and the disconnected ends of the intestine are connected together. This can be done in different ways. In some cases, it is not possible to connect the end straight away, and more time is needed to allow the intestine to grow. In the meantime, a temporary opening in the belly can be created for waste to pass through. This opening is called a stoma. After surgery, most children will be able to feed normally. However, whilst their intestines recover, children will often need to receive extra nutrition via a tube that delivers it to the body through a vein. This is called parenteral nutrition, and it may be needed for a period of days, weeks or months after surgery. In some cases, further surgery may be needed if the intestine does not recover well. The amount of time your baby will spend in hospital will differ depending on the severity of the small bowel atresia, any complications, and how well they respond to treatment. Follow up care by a team of different clinical specialists is required for babies with small bowel atresia. This team is often called a multidisciplinary team, or MDT. Some babies may experience ongoing difficulties that require different types and levels of care. Some babies may require parenteral nutrition for a longer period if a large part of the small intestine is missing. In most cases, this can be administered at home under the guidance of specialist clinicians. Peer support can be accessed through patient and family support groups.