Characteristic Radiological findings in Preterm Infants with Missed Intestinal Perforation
نویسندگان
چکیده
BACKGROUND Pneumoperitoneum on radiological imaging is typical in intestinal perforation in necrotizing enterocolitis [NEC]. However, it is not seen in all cases and intestinal perforation is missed on occasions. We present a series of preterm infants with characteristic x-ray findings that on exploration revealed missed intestinal perforation. METHODS Retrospective review of neonates with intra-operative diagnosis of intestinal perforation which was missed on x-ray abdomen over a period of 6 months is being presented here. RESULTS Three neonates born at 24 (24-30) weeks of gestation were identified. PDA was noted in all 3 patients and they required ventilator and inotropic support. Feeds were commenced at 5 (2-7) days of life. All three patients were treated for NEC. Surgical opinion was sought in view of localized gas shadow in a fixed position seen on repeated x-rays in all three patients. All three patients had laparotomy and small bowel resection with ileostomy formation at a mean age of 26 (24-46) days. Intra-operatively, small bowel perforation and adjacent pseudocysts filled with air and intestinal contents were noted in all 3 patients. Post-operatively full feeds were established in all patients. CONCLUSION In premature infants with NEC, intestinal perforation can be missed on occasions. Our patients interestingly, developed characteristic abdominal x-ray findings that in our experience should prompt for surgical intervention.
منابع مشابه
Spontaneous intestinal perforation.
Neonatal necrotizing enterocolitis, the most common gastrointestinal emergency in neonates, typically affects the preterm infants and carries high mortality. Classic clinical trad consists of abdominal distension, bloody stools, and pneumatosis intestinalis. Occasionally, signs and symptoms may not be classic and a number of papers have highlighted the difficulty of relying on radiological feat...
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Comparison of gastric and other bowel perforations in preterm infants: a review of 20 years' experience in a single institution
PURPOSE In this study, we aimed to review the clinical presentation of preterm infants with gastrointestinal perforations and compare the clinical features of gastric perforation with other intestinal perforations. METHODS The medical records of preterm neonates with pneumoperitoneum, admitted to the neonatal intensive care unit (NICU) between January 1994 and December 2013, were retrospectiv...
متن کاملDelayed Meconium Passage in Small vs. Appropriate for Gestational Age Preterm Infants: Management and Short-Term Outcome
OBJECTIVE Delayed passage of stool is a result of both gestational immaturity and illness severity. Small for gestational age (SGA) preterm infants are at high risk of gastrointestinal (GI) complications. We aimed to analyse the effects of a strict nutrition and stool protocol on GI problems in SGA compared to appropriate for gestational age (AGA) preterm infants. METHODS Retrospective cohort...
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عنوان ژورنال:
دوره 3 شماره
صفحات -
تاریخ انتشار 2014