Congenital Intestinal Atresia: Observations on its Origin
The commonly accepted theory of the pathogenesis of congenital intestinal atresia is that it results from a non-recanalization of the gut. On the basis of clinical observations the authors conceived the idea that some atresias may be due to interference with the blood supply to a portion of the fetal gut. The authors attempted to reproduce the anomaly in animals by interfering with the blood supply to a segment of the bowel in the fetus in one of which an anomaly of the gut identical with that found in infants with intestinal atresia was produced. Certain facts which cannot be explained by the now commonly held theory of non-recanalization are mentioned. On the basis of their clinical observations and the animal experiments the authors suggest that at least some cases of congenital intestinal atresia result from interference of the blood supply to a segment of the fetal bowel. Possible causes of such vascular obstruction in human fetus include intrauterine volvulus and intussusception. In 45 per cent of mid-gut atresias there is malfixation of the mesentary, which may be a predisposing factor.
