Intestinal Atresia: Types, Symptoms, and Treatment
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Intestinal atresia is a condition present at birth in which part of the intestine, most commonly the small intestine, is narrowed, blocked or missing. Signs include abdominal swelling, bile-colored vomiting and not passing the first stool, usually within the first 24 to 48 hours of life. Treatment is surgery to remove the blocked section and reconnect the healthy ends. [1]
What the research says
Outcomes are generally good, with a small share needing further procedures. A ten-year review at one children's hospital (75 infants with intestinal atresia) found isolated duodenal atresia in 49.3%, jejunal in 32%, ileal in 12%, mixed atresias in 4%, and pyloric and colonic atresia in 1.3% each. Malrotation was associated with 13% of patients. Most infants with jejunoileal atresia had resection with primary anastomosis, 11% needed a later procedure for stricture or small bowel obstruction, and there was one death. The authors concluded that these infants have low morbidity and mortality and rarely need reoperation. (Koenig et al., J Surg Res, 2024)
Duodenal and jejunoileal atresia behave differently. A Pediatrics in Review article explains that duodenal atresia and jejunoileal atresia are distinct entities, that both can be suspected on fetal imaging to help prenatal counseling, and that duodenal atresia is more often associated with other conditions while jejunoileal atresia is more often isolated. Surgical repair is essential and typically well tolerated, and excellent short- and long-term outcomes are expected for isolated cases. (Rich et al., Pediatr Rev, 2022)
What is intestinal atresia?
Intestinal atresia (pronounced "a-TREE-zhuh") is a condition present at birth in which part of a newborn's intestine is narrowed, blocked or missing. This prevents food and fluid from moving through the intestine the way it should. It can occur anywhere along the gastrointestinal tract but most commonly affects the small intestine, which digests food and absorbs nutrients. [1]
Without treatment, intestinal atresia can lead to nutritional problems and other serious complications. With early diagnosis and treatment, most babies have very good outcomes with no further problems. [1]
Types of intestinal atresia
The type depends on where the blockage happens. [1]
Type | Where it occurs | How common |
Duodenal atresia | The first part of the small intestine (duodenum) [1] | The most common type, about half of all small intestinal blockages [1] |
Jejunal atresia | The middle part of the small intestine (jejunum) [1] | About 1 in 5 cases [1] |
Ileal atresia | The lower part of the small intestine (ileum) [1] | About 1 in 5 cases [1] |
Colonic atresia | Any part of the large intestine (colon) [1] | The rarest type [1] |
Symptoms
Symptoms happen because food and other contents build up behind the blockage. They usually appear within the first 24 to 48 hours of life. [1]
Abdominal swelling
Vomiting, often green, yellow or brown bile
Not passing the first poop (meconium)
Trouble feeding
Take your baby to their healthcare provider right away if they're not pooping or have a swollen belly, vomiting or trouble feeding. [1]
Causes and risk factors
Most of the time, intestinal atresia happens when something interrupts blood flow to the fetus's intestine during development. Providers sometimes call this an in utero vascular accident. Without enough blood, part of the intestine doesn't form correctly. [1]
Duodenal atresias are often linked to genetic conditions such as Down syndrome. Other intestinal atresias are often isolated vascular problems. [1]
Complications
Without treatment, intestinal atresia can lead to infection, feeding problems, poor growth, severe bowel blockage and death. [1]
How intestinal atresia is diagnosed
A provider may find intestinal atresia before or shortly after birth. [1]
During pregnancy
Routine ultrasounds may show signs that suggest the condition: [1]
Polyhydramnios: excess amniotic fluid in the uterus, because the fetus can't swallow and absorb the fluid properly.
Dilated or bright (echogenic) bowel loops: parts of the intestines look larger or brighter than usual.
Double bubble: a classic sign of duodenal atresia, showing two fluid-filled areas, the stomach and the first part of the duodenum.
After birth
Symptoms of a bowel blockage may lead the newborn's provider to request further testing, which may include: [1]
Abdominal X-rays
An upper GI contrast study
A contrast enema
Blood tests
An echocardiogram
A kidney ultrasound
Because other birth defects can occur with atresia, the echocardiogram and kidney ultrasound help check the heart and kidneys. Malrotation, a problem with how the intestine is positioned, was associated with 13% of patients in one ten-year series. (Koenig et al., 2024)
Treatment
Intestinal atresia requires surgery after birth. A pediatric surgeon removes the narrowed or blocked section of the intestine and reconnects the healthy ends so the bowel can work normally. If the bowel isn't in good shape at the operation, a temporary stoma is sometimes needed. [1]
Recovery
Recovery time varies. Most babies gradually regain the use of their intestines over the next several days or weeks. You'll slowly begin feeding your baby breast milk, or they'll receive formula through a tube. Some babies need feedings through an IV (total parenteral nutrition, or TPN), which is usually temporary until they can tolerate full feeds. [1]
The healthcare team also monitors for complications such as infection, narrowing at the surgical site and short bowel syndrome. Providers often treat these complications successfully. [1]
Outlook
Most babies do very well after surgery. Outcomes depend on which part of the intestine is affected, how much intestine is involved and whether other conditions are present. Some babies with complex atresia may need extra nutritional support, and some may develop late complications, but with early diagnosis and surgical treatment most babies recover fully and feed and grow normally. [1]
Frequently Asked Questions
How soon is surgery performed after birth?
Intestinal atresia needs operative repair in the early newborn period, once the baby is stable enough for surgery.
Can intestinal atresia be prevented?
Intestinal atresia usually results from an interruption of blood flow during fetal development, and the sources reviewed describe no proven way to prevent it. Routine prenatal ultrasounds can help detect it early.
Will my baby be able to breastfeed after surgery?
Often yes. After surgery you slowly begin feeding your baby breast milk, or they receive formula through a tube. Some babies need IV nutrition until they can tolerate full feeds.
What is the double bubble sign?
The double bubble sign is an ultrasound finding of two fluid-filled areas, the stomach and the first part of the duodenum. It is a classic sign of duodenal atresia.
Is intestinal atresia hereditary?
Most cases are isolated vascular problems. Duodenal atresia is often linked to genetic conditions such as Down syndrome.
How long will my baby stay in the hospital?
It varies. Most babies gradually regain the use of their intestines over the next several days or weeks, and the stay depends on how complex the surgery is and how soon full feeds are tolerated.
What is polyhydramnios?
Polyhydramnios is excess amniotic fluid in the uterus. In intestinal atresia it happens because the fetus can't swallow and absorb the fluid properly.
Can a baby have more than one atresia?
Yes. In a ten-year review of 75 infants, some had multiple atresias, and 4% had mixed atresias.
What are the risks of leaving it untreated?
Without treatment, intestinal atresia can lead to infection, feeding problems, poor growth, severe bowel blockage and death.
What is a stoma?
A stoma is a surgically created opening in the abdomen. A temporary stoma is sometimes needed if the bowel isn't in good shape at the operation.
What is total parenteral nutrition (TPN)?
TPN is nutrition given through an IV. It is usually temporary, until the baby can tolerate full feeds.
Does intestinal atresia affect other organs?
Intestinal atresia can occur with other birth defects, so providers may order an echocardiogram and kidney ultrasound. Duodenal atresia in particular is often linked to genetic conditions such as Down syndrome.
What is meconium?
Meconium is a newborn's first stool. Not passing it is one of the early signs of a bowel blockage.
Which complications can happen after surgery?
The team monitors for infection, narrowing at the surgical site and short bowel syndrome. Providers often treat these successfully. In one ten-year series, 11% of infants needed a later procedure for stricture or small bowel obstruction.
What is the long-term outlook?
Most babies do very well. With early diagnosis and surgery, most recover fully and feed and grow normally, though outcomes depend on the part and amount of intestine involved and on other conditions.
When should I take my baby to the doctor?
Right away if your baby isn't pooping or has a swollen belly, vomiting or trouble feeding.
References
Cleveland Clinic. Intestinal Atresia. Cleveland Clinic. Last updated April 23, 2026. https://my.clevelandclinic.org/health/diseases/intestinal-atresia
Koenig SM, Russell RT, Quevedo OG, et al. Intestinal Atresias: A Ten-Year Evaluation of Outcomes. J Surg Res. 2024;296:130-134. PMID 38277948. https://doi.org/10.1016/j.jss.2023.12.015
Rich BS, Bornstein E, Dolgin SE. Intestinal Atresias. Pediatr Rev. 2022;43(5):266-274. PMID 35490204. https://doi.org/10.1542/pir.2021-005177
Medical disclaimer
This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If you think you may have a medical emergency, call your doctor or 911 immediately.
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