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Jejunal and ileal atresia are congenital anomalies involving complete obstruction of the small bowel due to developmental failure during fetal life. These conditions present as neonatal bowel obstruction with bilious vomiting, abdominal distension, and failure to pass meconium within 24-48 hours of birth.
The atresia results from in utero vascular accidents, particularly superior mesenteric artery occlusion, leading to bowel ischemia and subsequent resorption of the affected segment. This creates a gap between the proximal dilated bowel and the distal collapsed bowel, with the mesentery showing a characteristic V-shaped defect and 'apple-peel' configuration in severe cases.
Diagnosis is suspected in newborns presenting with bilious vomiting and confirmed by abdominal X-rays showing dilated bowel loops with air-fluid levels and absence of gas in the distal bowel. Upper GI contrast studies help differentiate the level of obstruction, while surgical exploration and primary anastomosis remain the definitive treatment, though outcomes depend on associated anomalies and bowel length preservation.