Monozygotic twins with jejuno-ileal atresia

Introduction: Intestinal atresia is a congenital anomaly of the alimentary canal characterised by discontinuity of the bowel lumen that leads to intestinal obstruction in neonates. To our knowledge there have only been seventeen cases of twin pair with intestinal atresia thus far. We report this case and summarise all twins described in the literature to date. This may allow for a twin study in the future to help elucidate the aetiology of intestinal atresia. Presentation of case: We report on a pair of twins both of whom were referred with bilious vomiting, epigastric fullness and granular stools. Both x-rays showed proximal enteric dilatation with paucity of distal bowel gas suggesting jejunal atresia. The preoperative clinical state precluded surgery and both children deteriorated despite maximum intensive care, eventually succumbing to sepsis. Post-mortem was performed revealing jejunal atresia in both twins. Zygosity tests revealed the twins were monozygotic. Discussion: Intestinal atresia is one of the most common cause of neonatal intestinal obstruction. Management of these neonates in the developing world is plagued with late presentation and referral contributing to adverse outcome. Expeditious diagnosis and appropriate referral are paramount to avert dehydration, sepsis and malnutrition. Conclusion: Intestinal atresia in both twins is a rare clinical entity. Twin-pairs present unique opportunities to investigate the aetiology of diseases. Keywords: Intestinal atresia, Twins, Neonatal surgery, Jejunoileal atresi