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夹闭前需三思:脐肠管离断。病例报告。

Look twice before you clamp: decapitation of an omphaloenteric duct. A case report.

作者信息

van Tuil Cornelia, Saxena Amulya K, Willital Gunter H

机构信息

Pediatric Surgical University Clinic, Munster, Germany.

出版信息

Med Princ Pract. 2006;15(2):156-8. doi: 10.1159/000090923.

Abstract

OBJECTIVE

To report a case of accidental decapitation of a persistent omphaloenteric duct (POD) in congenital hernia of the umbilical cord in a newborn male.

CASE PRESENTATION AND INTERVENTION

The newborn was transferred to an intensive care unit, where under closer inspection the diagnosis of an omphalocele was presumed. Surgical exploration at our Pediatric Surgical University Clinic revealed a clamped and decapitated POD in the umbilical cord. The decapitation had gone unnoticed due to severe asphyxia resulting from meconium aspiration encountered at the time of delivery. Using general anesthesia, the clamp was removed under sterile conditions. The decapitation of the POD in the herniated umbilical cord was confirmed at this time. The severed intestine was sutured and closed using 5-0 Vicryl sutures. The further course was uneventful.

CONCLUSION

Herniation of the umbilical cord at the time of birth by intestinal loops or POD is rare, but caution should be taken by midwives before clamping in order to avoid the type of injury seen in this case.

摘要

目的

报告一例新生儿男性先天性脐疝中持续性卵黄管(POD)意外断头的病例。

病例介绍及干预

该新生儿被转入重症监护病房,经仔细检查推测诊断为脐膨出。我们的儿科外科大学诊所进行手术探查时发现脐带中有一个被夹住且断头的POD。由于分娩时遇到胎粪吸入导致严重窒息,断头情况未被注意到。在全身麻醉下,在无菌条件下移除夹子。此时证实了疝出脐带中的POD断头。用5-0薇乔缝线缝合并闭合切断的肠管。后续过程顺利。

结论

出生时肠袢或POD导致脐带疝很少见,但助产士在夹脐带前应谨慎操作,以避免出现本病例中所见的损伤类型。

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