Weinberg G, Kleinhaus S, Boley S J
Division of Pediatric Surgery, Montefiore Medical Center, New York, NY.
J Pediatr Surg. 1989 Oct;24(10):1007-8. doi: 10.1016/s0022-3468(89)80203-9.
Between 1982 and 1987 seven neonates ranging in age from 24 hours to 1 week were treated for idiopathic intestinal perforations at the Montefiore Medical Center, Albert Einstein College of Medicine. Four of the infants were born prematurely; three were full term. Five were being treated in an intensive care nursery when the perforation was diagnosed. All infants whose perforations were due to necrotizing enterocolitis, appendicitis, Hirschsprung's disease, meconium ileus, intestinal atresias, or drug therapy are excluded from the series. None of the infants had associated anomalies. The sites of the perforations were as follows: two in the jejunum, two in the ileum, one in the cecum, and two in the transverse colon. Six of the perforations were on the antimesenteric aspect of the bowel; one was on the mesenteric aspect. The sizes of the perforations ranged from pinhole to 1 cm in diameter. All the infants did well. Pathologic examination of the resected specimens failed to reveal an etiology for the perforations. There were no cases of duplication or muscular hypoplasia. We believe the etiology of this condition may be ischemic necrosis, secondary to a localized vascular accident in the wall of the affected viscus, but we do not have a good explanation for the upsurge in cases we are seeing.
1982年至1987年间，阿尔伯特·爱因斯坦医学院蒙特菲奥里医疗中心对7名年龄在24小时至1周之间的新生儿进行了特发性肠穿孔治疗。其中4名婴儿为早产儿；3名足月出生。5名婴儿在穿孔被诊断时正在重症监护病房接受治疗。所有因坏死性小肠结肠炎、阑尾炎、先天性巨结肠、胎粪性肠梗阻、肠闭锁或药物治疗导致穿孔的婴儿均被排除在该系列之外。所有婴儿均无相关畸形。穿孔部位如下：空肠2处，回肠2处，盲肠1处，横结肠2处。6处穿孔位于肠管的系膜对侧；1处位于系膜侧。穿孔大小从针孔到直径1厘米不等。所有婴儿恢复良好。切除标本的病理检查未能揭示穿孔的病因。没有重复畸形或肌肉发育不全的病例。我们认为这种情况的病因可能是缺血性坏死，继发于受累脏器壁的局部血管意外，但对于我们所见到的病例数量增加，我们没有很好的解释。
