Medicine, University of Leicester, Leicester, UK
Medicine, University of Leicester, Leicester, UK.
BMJ Case Rep. 2023 Sep 20;16(9):e251783. doi: 10.1136/bcr-2022-251783.
A term newborn presented after birth with abdominal distension and vomiting in a developing country in Asia. Ultrasonography suggested intestinal obstruction and abdominal X-ray showed a 'double-bubble' sign suggestive of intestinal atresia. The newborn was diagnosed with early-onset neonatal sepsis secondary to intestinal obstruction and transferred to the neonatal intensive care unit. Surgery was performed and type IIIb jejunal atresia was found. Type IIIa/b jejunal atresia is associated with high incidence of poor outcome in lower socioeconomic countries. The affected intestinal segment and a distal serosal tear were resected and two end-to-end anastomoses formed. Oral feeding commenced on day 13 postoperatively. The patient was discharged on day 20 with adequate nutritional status. At follow-up, the patient continued to thrive. An operation involving resection of two different segments of bowel repaired with two end-to-end anastomoses in a neonate had a successful outcome for the patient.
一个足月新生儿在亚洲发展中国家出生后出现腹部膨胀和呕吐。超声检查提示肠梗阻,腹部 X 光片显示“双泡”征提示肠闭锁。新生儿被诊断为早期新生儿败血症,继发于肠梗阻,并转至新生儿重症监护病房。手术发现为 IIIb 型空肠闭锁。IIIa/b 型空肠闭锁与社会经济水平较低的国家中不良预后发生率高有关。切除受累肠段和远端浆膜撕裂,并形成两个端端吻合。术后第 13 天开始口服喂养。患儿于术后第 20 天出院,营养状况良好。随访时,患儿生长良好。对于该新生儿,涉及切除两段不同肠段并用两个端端吻合修复的手术取得了成功。