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子宫内中肠扭转作为肠梗阻的罕见病因:病例报告。

Intrauterine midgut volvulus as a rare cause of intestinal obstruction: a case report.

机构信息

Department of Pediatric Surgery, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey.

Department of Pediatric, Şanlıurfa Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkey.

出版信息

J Med Case Rep. 2021 May 4;15(1):239. doi: 10.1186/s13256-021-02778-6.

Abstract

BACKGROUND

Intrauterine midgut volvulus is a very rare, life-threatening condition, and prenatal diagnosis is difficult. In this article, we present a case of midgut volvulus followed by a pre-diagnosis of antenatal jejunal atresia.

CASE PRESENTATION

A 1-day-old Turkish male baby, who was followed with a diagnosis of antenatal jejunal atresia, with a birth weight of 3600 g, delivered by cesarean section at 38 weeks of gestation from a 19-year-old mother in her fourth pregnancy, was taken to the newborn intensive care unit. The patient underwent surgery on the postnatal first day with a preliminary diagnosis of jejunal atresia. It was observed that the small intestine was rotated two full cycles from the mesenteric root. Bowel blood circulation was good. Volvulus was untwisted. There was malrotation. Ladd's procedure was performed. The baby was discharged on the seventh postoperative day with full oral feeding. The patient is still in the first postoperative year and follow-up has been uneventful.

CONCLUSION

Intrauterine midgut volvulus has been associated with high mortality in the literature. Differential diagnosis of midgut volvulus in patients with antenatal intestinal obstruction, close prenatal follow-up, appropriate delivery and timing of surgical intervention may significantly reduce morbidity and mortality.

摘要

背景

子宫内中肠扭转是一种非常罕见的、危及生命的疾病,产前诊断困难。本文介绍了一例中肠扭转病例,产前诊断为先天性回肠闭锁。

病例介绍

一名 1 天龄的土耳其男婴,因产前诊断为先天性回肠闭锁,出生体重 3600 克,由 19 岁的母亲经剖宫产于孕 38 周分娩,转至新生儿重症监护病房。患儿于出生后第 1 天接受手术,初步诊断为回肠闭锁。术中发现小肠从肠系膜根部旋转了两整圈。肠血运良好,扭转得到松解。行 Ladd 手术。术后第 7 天患儿顺利出院,开始全口服喂养。患儿仍在术后第 1 年,随访无异常。

结论

文献报道子宫内中肠扭转死亡率高。对于产前肠梗阻的患者,中肠扭转的鉴别诊断,密切的产前随访,适当的分娩方式和手术干预时机,可能显著降低发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ca6/8094507/cc00dec1046b/13256_2021_2778_Fig1_HTML.jpg

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