Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
BMC Pediatr. 2022 Jun 3;22(1):327. doi: 10.1186/s12887-022-03392-1.
Despite the relative prevalence of small bowel and proximal colon perforation in the neonatal period, recto-sigmoid perforation is extremely rare. Full-term neonates experience intestinal perforation less frequently than premature infants. Here we report a neonate with sigmoid perforation and simultaneous Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection.
A 2550 g female neonate born at 38-weeks' gestation from a coronavirus disease-2019 (COVID-19) infected mother by cesarean section. Despite a good Apgar score in the first and fifth minutes, she was admitted to the neonatal intensive care unit with grunting and mild respiratory distress. She underwent antibiotics and oxygen by head box resulting in an Oxygen Saturation rate of 94%. The patients' respiratory distress decreased during the second day, resulting once breastfeeding without tolerance. While she passed meconium in the first 2 days, she developed abdominal distention on day 3. The nasopharyngeal SARS-CoV-2 real-time polymerase chain reaction (RT-PCR) was performed with positive results. Surgical consultation was requested and a thoraco-abdominal X-Ray was performed at this stage, which suspected to be a gastrointestinal perforation. Due to clinical deterioration and persistent abdominal distention, a contrast study was performed with water-soluble contrast, which confirmed intestinal perforation. However, the surgical exploration revealed perforation of the sigmoid colon at the posterior segment. The patient underwent antibiotic therapy, abdominal lavage, and colostomy, immediately. She was discharged in good condition approximately 14-days later.
To our knowledge, this is the first report of sigmoid colon perforation in a term neonate following COVID-19.
尽管在新生儿期小肠和近端结肠穿孔相对常见，但直肠乙状结肠穿孔极为罕见。足月新生儿发生肠穿孔的频率低于早产儿。本文报告了一例同时患有严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）感染的足月新生儿乙状结肠穿孔病例。
一名 2550g 女性新生儿，因母亲感染 2019 年冠状病毒病（COVID-19）行剖宫产于 38 周时出生。尽管第 1 分钟和第 5 分钟的阿普加评分良好，但她因呻吟和轻度呼吸窘迫而被收入新生儿重症监护病房。她接受了抗生素和头罩吸氧治疗，氧饱和度为 94%。第 2 天，患者的呼吸窘迫减轻，开始母乳喂养，但不耐受。尽管在最初的 2 天内排胎便，但在第 3 天出现腹胀。行鼻咽 SARS-CoV-2 实时聚合酶链反应（RT-PCR）检测结果阳性。此时请外科会诊，并进行了胸腹 X 线检查，疑似胃肠道穿孔。由于临床恶化和持续腹胀，进行水溶性造影剂对比研究，证实了肠穿孔。然而，外科探查发现乙状结肠后段穿孔。患者立即接受抗生素治疗、腹腔灌洗和结肠造口术。大约 14 天后，患者病情好转出院。
据我们所知，这是首例 COVID-19 后足月新生儿发生乙状结肠穿孔的报告。
