Atresia of the Jejunum, Ileum, and Colon Unlike duodenal atresia, more distal intestinal atresias are caused

not by a failure of canalization but by a mesenteric vascular accident with resultant aseptic resorption of the bowel, usually later in gestation. The spectrum of anomalies ranges from a stenosis or mucosal web (type I), a fibrous cord between two bowel ends (type II), to blind-ending proximal and distal bowel loops with a V-shaped mesenteric defect 29 (type IIIa), and multiple atresias of any kind (type IV). The most common site of atresia is the ileum, followed by the jejunum and the colon. Bilious emesis is uniform. Plain radiographs demonstrating only a few dilated bowel loops are indicative of a proximal obstruction, and a contrast study is not required. At operation, the distal portion of the proximal blind-ending bowel segment is disproportionally dilated and should be resected because it is functionally abnormal and atonic. There is always a discrepancy in bowel diameter between the proximal and distal ends, so an end-to-side or end-to-oblique anastomosis is necessary.