Gerçel Gonca, Anadolulu Ali İhsan
Şanlıurfa Training and Research Hospital Clinic of Pediatric Surgery, Şanlıurfa, Turkey.
Mehmet Akif İnan Training and Research Hospital Clinic of Pediatric Surgery, Şanlıurfa, Turkey.
Int J Surg Case Rep. 2022 Sep;98:107548. doi: 10.1016/j.ijscr.2022.107548. Epub 2022 Aug 24.
We aimed to report a case of acute mesenteric ischemia in a newborn with COVID-19.
A 1-day-old male baby, with a birth weight of 2050 g, delivered by spontaneous vaginal delivery at 34 weeks of gestation from a 32-year-old COVID-19 infected mother in her third pregnancy, was taken to the newborn intensive care unit. On physical examination, the patient was alive and active. The abdomen was soft. Laboratory values of the patient were within the normal range. Echocardiography and abdominal ultrasonography were normal. COVID-19 PCR test drawn at 48 h of age was positive. On the postnatal 4th day, the patient suddenly had tachycardia and abdominal tension. Free air in the abdomen was detected on direct abdominal X-ray. The patient was taken to surgery urgently. On laparotomy, brownish ascites and necrotic small bowel and colon starting from 20 cm of ligamentum of Treitz to the middle part of the transverse colon were seen. Jejunostomy was constructed at area that 50 cm distal to Treitz with a relatively better appearance (with circulatory disorder but not full-thickness necrosis) and transverse colon mucous fistula without primary anastomosis. The patient died one day after surgery due to cardiorespiratory arrest and multiorgan failure.
Although most of the reported symptoms of the COVID-19 are related to the respiratory system, there is concern that the occurrence of serious and life-threatening manifestations such as mesenteric ischemia in the gastrointestinal tract may be overlooked in also neonatal period.
我们旨在报告1例患有新型冠状病毒肺炎（COVID-19）的新生儿急性肠系膜缺血病例。
一名1日龄男婴，出生体重2050g，孕34周时经阴道自然分娩，其母亲为一名32岁的COVID-19感染患者，这是她的第三次妊娠。该男婴被送入新生儿重症监护病房。体格检查时，患儿生命体征平稳且活动良好。腹部柔软。患儿的实验室检查值在正常范围内。超声心动图和腹部超声检查均正常。出生48小时时进行的COVID-19聚合酶链反应（PCR）检测呈阳性。出生后第4天，患儿突然出现心动过速和腹部张力增加。腹部X线直接检查发现腹腔内有游离气体。患儿被紧急送往手术室。剖腹探查时，可见从屈氏韧带20cm处至横结肠中部有褐色腹水、坏死的小肠和结肠。在距屈氏韧带远端50cm处外观相对较好（有循环障碍但无全层坏死）的区域行空肠造口术，并做横结肠黏液瘘，未进行一期吻合。患儿术后1天因心肺骤停和多器官功能衰竭死亡。
尽管报告的COVID-19的大多数症状与呼吸系统有关，但人们担心在新生儿期也可能会忽视胃肠道中肠系膜缺血等严重和危及生命的表现的发生。
