Amano Hizuru, Uchida Hiroo, Kawashima Hiroshi, Tanaka Yujiro, Kishimoto Hiroshi
Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nagoya J Med Sci. 2014 Aug;76(3-4):375-80.
Midgut volvulus is a highly life-threatening condition that carries a high risk of short gut syndrome. We report a case of catastrophic neonatal midgut volvulus in which second-look laparotomy revealed apparently non-viable remnant small intestine but with a moderate blood supply. Full-thickness small intestine necrosis was distributed in a patchy fashion, with non-viable and necrotic areas distributed so widely that no portion of the intestine could be resected. A section of full-thickness necrotic intestine preserved at surgery was able to regenerate, and normal function was restored over a period of 1 month. This case indicated that intestinal resumption may be dependent on blood flow. Even when intestinal viability is questionable, preservation enables the chance of regeneration if moderate blood flow is present.
中肠扭转是一种极具生命威胁的疾病，会导致短肠综合征的高风险。我们报告一例灾难性新生儿中肠扭转病例，二次剖腹探查显示残余小肠明显无活力，但血供尚可。全层小肠坏死呈斑片状分布，无活力和坏死区域分布广泛，以至于无法切除任何一段肠管。手术中保留的一段全层坏死肠管能够再生，并在1个月内恢复了正常功能。该病例表明肠道恢复可能依赖于血流。即使肠道活力存疑，若有适度血流，保留肠管就能提供再生的机会。
