ADDITIONAL CONGENITAL-ANOMALIES IN BABIES WITH GUT ATRESIA OR STENOSIS - WHEN TO INVESTIGATE, AND WHICH INVESTIGATION

A wide variety of additional congenital anomalies occur in babies born with a gut atresia or stenosis. The specific pattern of anomalies dep ends on the location of the atresia. The serious nature of many of the m makes perioperative diagnosis imperative. Eighty-six babies born wit h pure oesophageal atresia (OA), duodenal atresia (DA) or stenosis, or jejuno-ileal atresia (JIA) have been studied. These, combined with ov er 2,000 cases in the literature, have been used to develop a protocol to optimally investigate babies with gut atresia for associated anoma lies. The authors recommend routinely obtaining anterio-posterior and lateral chest and abdominal radiographs for babies with pure OA, DA an d intestinal atresia, making sure the entire spine can be visualised. Cardiac and renal ultrasonography (US) should be routine in all babies with pure OA or DA. A micturating cystourethrogram should be done in those babies with abnormal urinary tract US or an associated anorectal anomaly. A sweat test should be obtained in babies with JIA, and a re ctal biopsy should be taken in babies with the combination of Down's s yndrome and DA to exclude Hirschsprung's disease.