Piplani Rajat, Acharya Samir K, Bagga Deepak
Department of Pediatric Surgery, V.M.M.C & Safdarjang Hospital, New Delhi.
J Neonatal Surg. 2017 Apr 15;6(2):35. doi: 10.21699/jns.v5i4.463. eCollection 2017 Apr-Jun.
We report a rare case of incomplete congenital duodenal obstruction (Type 1 duodenal atresia) in association with situs inversus totalis presenting with gastric perforation in a neonate. The infantogram was suggestive of perforation with air under diaphragm along with dextrocardia. On exploration, a pin point perforation at fundus near lesser curvature along with situs inversus was noted. Primary closure of gastric perforation was done. Patient was then discharged on full breast feeds but was readmitted with intolerance to feeds and recurrent bilious vomiting. Further, upper GI contrast study revealed partial duodenal obstruction. On re-exploration, duodenal web with central aperture was seen and duodeno-duodenostomy was done.
我们报告了一例罕见的不完全先天性十二指肠梗阻（1型十二指肠闭锁）合并全内脏转位的新生儿病例，该患儿出现胃穿孔。婴儿腹平片提示膈下游离气体伴胃穿孔以及右位心。术中探查发现胃小弯附近胃底有一个针尖样穿孔，同时存在全内脏转位。对胃穿孔进行了一期缝合。患儿随后开始全母乳喂养并出院，但因喂养不耐受和反复胆汁性呕吐再次入院。进一步的上消化道造影检查显示部分十二指肠梗阻。再次手术探查时，发现十二指肠隔膜并伴有中央孔，遂行十二指肠十二指肠吻合术。
