Fig. 1
Types of intestinal atresia. In Type I, there is a muscular wall without lumen connecting the two ends of atretic bowel. In Type II, they are connected by a fibrous cord. In Type IIIa, there is a wedge-shaped gap in the mesentery between the two ends. Type IIIb is a severe form of the disease in which the only distal bowel present is spiraled around a branch of the ileocecal artery. Type IV is multiple atresias (Source: Christopher Coppola)
(i)
Type I: Atretic bowel has no lumen, but muscular wall is intact.
(ii)
Type II: The atretic segment is a fibrous cord, with no muscular wall.
(iii)
Type III: There is absence of the bowel and a wedge-shaped gap in the mesentery.
1.
Type IIIa: simple defect of limited length.
2.
Type IIIb: This is the dreaded “Christmas tree” or “apple peel” deformity where the bowel ends blindly shortly after the ligament of Treitz. The only distal bowel present is a stenotic spiral wrapped around the ileocecal artery like the coiled peel from an apple. The base of the coil is wider than the tip, giving the cone-shaped appearance of a Christmas tree. Patients with this defect will often have short gut syndrome.
(iv)
Type IV: Multiple segments of intestinal atresia.
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