Late presentation of jejunal atresia: a case report and review of literature

Introduction: Late-presenting type I jejunal atresia is rare and often difficult to diagnose, as partial obstruction may mimic common pediatric conditions such as gastroesophageal reflux disease or pyloric stenosis. Patient concerns and clinical findings: A 9-month-old female infant, the first child of healthy parents, presented with persistent, non-bilious, postprandial vomiting and poor weight gain. Routine abdominal radiographs, ultrasonography, and upper gastrointestinal contrast studies were unremarkable. Stool frequency and consistency remained normal. Diagnosis, therapeutic interventions, and outcomes: Given persistent symptoms and inconclusive imaging, an exploratory laparotomy was performed, revealing a type I jejunal atresia located 10 cm distal to the duodenojejunal flexure. A diamond-shaped (Kimura) jejunojejunostomy was performed to address the proximal-distal luminal discrepancy. The postoperative course was uneventful, and the patient tolerated feeds well with gradual weight gain. Conclusion: This case highlights that type I jejunal atresia can present beyond the neonatal period with subtle or atypical features. Infants with persistent vomiting and poor weight gain, even when imaging appears normal, should be evaluated for late-presenting congenital intestinal obstruction. Awareness of this rare presentation and appropriate surgical intervention are critical for favorable outcomes.