Two cases of intussusception in infants born at 26 and 30 weeks' gestation are described. The two infants presented in the neonatal period with abdominal distension, intolerance of feeds, and rectal bleeding. An initial diagnosis of necrotising enterocolitis was made and the infants were treated medically. This led to a delay in the diagnosis of the intussusception. Published work on neonatal intussusception is reviewed and attention is drawn to the fact that the presenting signs and symptoms can be similar to those of necrotising enterocolitis. A diagnosis of intussusception should therefore be considered in any preterm infant with suspected necrotising enterocolitis.
: Neonatal intussusception in premature infants is uncommon and may mimic other abdominal disorders. We present a case of intussusception in a very low birthweight neonate. Presenting signs initially suggested necrotizing enterocolitis and meconium disease, and the diagnosis was confirmed at laparotomy.
Two premature infants whose clinical picture initially was that of necrotizing enterocolitis eventually developed intussusception. The symptomatology of these two conditions is similar, and when they coexist, recognition of a complicating intussusception is difficult. The pathogenic relationship between necrotizing en terocolitis and intussusception remains obscure. The possibility that necrotizing enterocolitis can be a leading point in the development of intussusception is dis cussed.
A prospective study, followed by a retrospective audit, was made of the radiographs and clinical features of 225 consecutive neonates with abdominal distension presenting during a period of 4 years. More than one major cause for the distension was found in a third of cases. Excluding cases of ano-rectal atresia, diagnostic difficulties were encountered in 31% of cases and, occasionally, the diagnosis was revised several times as investigations proceeded. Neuhauser's sign of ‘bubbly’ meconium is ...
Between 1974 and 1979, 15 extremely ill neonates with necrotizing enterocolitis (NEC) were initially treated with peritoneal drainage under local anesthesia for intestinal perforation. They weighed 600 to 3040 g with half less than 1000 g. Most had other serious illnesses (RDS, PDA, jaundice, CNS abnormalities). There were no immediate complications such as hemorrhage or bowel evisceration from the local drainage procedures. Seven, of the 15 (46%) survived. Three (20%) died because of unrelated ...
Last. David Girvan(UWO: University of Western Ontario)H-Index: 5
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Abstract During 1974 and 1975, five newborn infants weighing between 760 and 1600 g developed severe intraabdominal complications of NEC due to necrotic bowel with perforation and peritonitis. Because these tiny neonates were very ill with sepsis and other severe medical problems, no attempt at laparotomy under general anesthesia was carried out. Instead, using local anesthesia, the contaminated peritoneal cavity was drained via a small incision, usually in the right lower quadrant. This permitt...
: Twelve cases of neonatal intussusception are presented and another 25 taken from the literature are reviewed. Intussusception in the first month of life is a distinct clinical and pathological entity, presenting as bowel obstruction in the first days and usually led by a tumor. In the past, a high mortality rate has been related to late diagnosis. The barium-enema examination is diagnostic.
Necrotizing enterocolitis (NEC) occasionally deviates from the classical presentation of the disease. Small bowel dilatation and pneumatosis are frequently present prior to the actual onset of the clinical presentation. Pneumatosis intestinalis, an important diagnostic sign of NEC, is quite variable; it may be present, persist, worsen, or disappear; or at times it may not be present at all. A severe complication of necrotizing enterocolitis is perforation which in 50 percent of the cases present...
Abstract We have presented two cases of intestinal atresia due to intrauterine intussusception and reviewed 22 Japanese cases collected through personal communication. Most of the infants were full-term and without other malformations; they passed meconium, even though the abdominal scout film suggested an ileal atresia. On barium enema, a normal size colon was frequently observed. At operation, the atresia in all cases was single, and cord or gap type, and their prognoses were excellent. A necr...
#1Akari Takai(Kyoto Prefectural University of Medicine)H-Index: 2
#2Tatsuji Hasegawa(Kyoto Prefectural University of Medicine)H-Index: 7
Last. Hajime Hosoi(Kyoto Prefectural University of Medicine)H-Index: 33
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A 613 g girl was born at 23 weeks of gestation by vaginal delivery due to maternal chorioamnionitis. She developed constipation and abdominal distention on day 2, a small amount of peritoneal fluid and low blood pressure on day 4 and bloody stool on day 6. Abdominal X-ray showed a non-specific bowel gas pattern. Necrotising enterocolitis (NEC) was suspected and treated by fasting, vasopressor support …
Resume L’invagination intestinale aigue est la cause la plus frequente d’occlusion intestinale chez le nourrisson et l’enfant de moins de 2 ans. Elle se definit comme la penetration d’un segment d’intestin dans la lumiere du segment qui lui est immediatement adjacent par un mecanisme de retournement en doigt de gant. Elle est liee a un trouble du peristaltisme intestinal dont l’etiologie est encore mal connue. L’incidence globale de l’invagination varie selon la zone geographique et le niveau sa...
La invaginacion intestinal aguda es la causa mas frecuente de oclusion intestinal en lactantes y ninos menores de 2 anos. Se define como la penetracion de un segmento de intestino en la luz del segmento inmediatamente adyacente por un mecanismo de inversion en dedo de guante. Se relaciona con un problema del peristaltismo intestinal cuya etiologia aun no se conoce por completo. La incidencia global de la invaginacion varia segun la zona geografica y el nivel sanitario. En mas del 60% de los caso...
Last. Sanjay Oak(King Edward Memorial Hospital)H-Index: 8
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Abstract Neonatal intestinal obstruction is an acute emergency with varied etiology. Neonatal jejunal polyp leading to intussusception and obstruction is extremely rare. We report a male newborn, diagnosed antenatally with intestinal obstruction. He also presented with abdominal distension. On exploration there was type III jejunal atresia with a 4 cm long segment of jejunojejunal intussusception with a polyp being the lead point. Resection anastomosis was done. Histopathology report was suggest...
Tonsilloliths are rare dystrophic calcification formed as a result of chronic inflammation of the tonsils. Tonsilloliths tend to occur more commonly with increasing age and are relatively rare in children. We report a case of unilateral tonsilloliths in an eight-year-old boy, who presented with earaches and history of regurgitating tiny yellowish-white foul smelling pellets. The tonsilloliths were successfully removed under local anaesthesia following which the symptoms subsided.
Resume Nous rapportons un cas d’invagination intestinale aigue (IIA) chez un nouveau-ne premature qui s’etait presente sous la forme d’une occlusion digestive haute tres precoce. Chez les nouveau-nes prematures, l’IIA est une affection rare. La presentation clinique est differente de celle des nourrissons et s’apparente a celle de l’enterocolite. Elle concerne plus souvent l’intestin grele et se complique volontiers de necrose intestinale car le diagnostic reste tardif, souvent peroperatoire. De...
