Jejunal Stenosis and Jejunal Web

  • Etiology: In utero vascular accident so it has no other associated congenital abnormalities
  • Imaging UpperGI: Jejunum is dilated while ileum is decompressed
  • DDX:
  • Complications:
  • Treatment: Surgical
  • Clinical:
    — Less severe form of jejunal atresia which often results in a delayed diagnosis
    — Much less common than jejunal atresia

Radiology Cases of Jejunal Stenosis

UGI of jejunal stenosis
Early (above) image from an UGI exam shows dilation of the stomach, duodenum, and proximal jejunum. Later image from the same exam (below) shows contrast progressing through the remainder of the jejunum, which is of a normal caliber.
UGI of jejunal stenosis
Delayed image from an upper GI with small bowel follow through exam shows the jejunum to be extremely dilated (left side of image) while the ileum is decompressed (right side of image).

Radiology Cases of Jejunal Web

AXR and upper GI of jejunal web
AXR supine (above left) shows dilation of the stomach and duodenum and a loop of proximal jejunum with a decompressed small bowel gas pattern distally. This is more clearly shown on the upper GI exam (above right). AXR left lateral decubitus (below) shows a triple bubble sign with a dilated duodenum in the middle of the image with a dilated stomach proximal to it and a dilated jejunum distal to it.

Surgery Cases of Jejunal Stenosis

Surgical image of jejunal stenosis
Surgical image shows the two retractors outlining a markedly dilated duodenum in the center of the image. The proximal jejunum is markedly stenotic where it joins to the duodenum at the duodenal-jejunal junction in the center of the image. The more distal jejunum is normal in caliber.

Surgery Cases of Jejunal Web

Surgical image of jejunal web
Surgical image shows an abrupt caliber change in the proximal jejunum.
Surgical image of jejunal stenosis due to jejunal web
Surgical image after the bowel has been incised shows a jejunal web within the bowel lumen.