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结肠闭锁和先天性巨结肠:病例报告及文献复习。

Colonic atresia and hirschsprung disease: a case report and review of the literature.

机构信息

Department of Surgery, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.

Department of Pediatrics, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.

出版信息

J Med Case Rep. 2023 Jun 7;17(1):233. doi: 10.1186/s13256-023-03969-z.

Abstract

BACKGROUND

Colon atresia is one of the rarest congenital anomalies of the gastrointestinal tract, with an incident range of between 1 in 10,000 and 66,000 live births. Type I colonic atresia affects only the mucosal layer of the intestine and spares the intestinal wall and mesentery. Hirschsprung Disease is a rare association of Colon atresia and is usually diagnosed as a complication of atresia treatment.

CASE PRESENTATION

This study reports a 14-h term white middle-eastern female infant with type I transverse colonic atresia complicated by the association of Hirschsprung disease and provides a brief literature review of the topic. She presented with poor feeding, weakness, and failure to pass meconium, and her abdominal X-ray showed complete distal bowel obstruction. The presence of Hirschsprung disease was realized after complications of atresia surgery. The infant underwent a total of three surgeries involving an end-to-end anastomosis of the atresia, colostomy formation following anastomosis leakage, and Hirschsprung surgery. The patient ultimately expired.

CONCLUSIONS

The association between colonic atresia and Hirschsprung disease poses a diagnostic and therapeutic challenge. Considering Hirschsprung disease as a possible association in colon atresia patients can facilitate proper decision-making in the course of treating colon atresia cases and achieving better outcomes.

摘要

背景

结肠闭锁是胃肠道最罕见的先天性异常之一,发生率为每 10000 至 66000 例活产儿中一例。I 型结肠闭锁仅影响肠黏膜层,而肠壁和肠系膜不受影响。先天性巨结肠是结肠闭锁的罕见伴发症,通常被诊断为闭锁治疗的并发症。

病例介绍

本研究报告了一例 14 小时龄的白种中东女性婴儿,患有 I 型横结肠闭锁,并发先天性巨结肠,并对该主题进行了简要的文献复习。患儿表现为喂养不良、虚弱和胎便排出不畅,其腹部 X 线片显示完全性远端肠阻塞。在闭锁手术后出现并发症后,才发现存在先天性巨结肠。患儿共经历了三次手术,包括闭锁的端端吻合、吻合口漏后的结肠造口术,以及先天性巨结肠手术。患儿最终死亡。

结论

结肠闭锁与先天性巨结肠之间的关联带来了诊断和治疗方面的挑战。在治疗结肠闭锁病例时,将先天性巨结肠视为可能的关联,可以帮助做出适当的决策,从而实现更好的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bde3/10246402/5459867d45e7/13256_2023_3969_Fig1_HTML.jpg

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