Alexander Frederick, Babak Dadvand, Goske Marilyn
Department of Pediatric Surgery, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
J Pediatr Surg. 2002 Nov;37(11):E34. doi: 10.1053/jpsu.2002.36206.
Multiple intestinal atresia presents a difficult technical problem because of extreme loss of intestinal length, disparity of residual bowel wall size, and discontinuity of multiple short intestinal segments. The authors report on a 3,000-g infant with gastroschisis complicated by intrauterine volvulus and multiple intestinal atresias who was treated successfully with intraluminal stenting and sutureless anastomoses. A total of 25 cm of small bowel was salvaged including 13 segments each measuring 1 to 8 cm in length. Subsequent radiographic studies showed spontaneous anastomosis with a compartmental configuration of the residual bowel and decreased transit time. Five months postoperatively, the patient was weaned off total parenteral nutrition completely and one year later is growing and gaining weight with 4 to 6 bowel movements per day.
由于肠道长度严重缺失、残留肠壁大小不均以及多个短肠段不连续，多发性肠闭锁带来了一个棘手的技术难题。作者报告了一名体重3000克的患有腹裂并合并宫内肠扭转和多发性肠闭锁的婴儿，该婴儿通过腔内支架置入和无缝合吻合术获得成功治疗。共挽救了25厘米的小肠，包括13个长度为1至8厘米的肠段。随后的影像学研究显示，残留肠管呈分区构型且自发吻合，转运时间缩短。术后五个月，患者完全停用了全胃肠外营养，一年后生长发育良好，体重增加，每天排便4至6次。
