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理解并处理一例脐膨出-膀胱外翻-肛门闭锁-脊柱裂综合征病例。

Understanding and managing a case of the omphalocele-exstrophy-imperforate anus-spinal defect complex.

作者信息

Nurani Khulud Mahmood, Abdalla Waleed, Ayub Khalid Mohamed

机构信息

Department of Human Anatomy and Medical Physiology, University of Nairobi, PO Box 43226-80100, Nairobi, Kenya.

Department of Surgery, Coast General Teaching and Referral Hospital, Mombasa, Kenya.

出版信息

J Surg Case Rep. 2024 Mar 17;2024(3):rjae166. doi: 10.1093/jscr/rjae166. eCollection 2024 Mar.

Abstract

The omphalocele-exstrophy-imperforate anus-spinal defects (OEIS) complex is a rare birth disorder involving a combination of gastrointestinal, musculoskeletal, renal, neural, and genitourinary system defects. We present a case report of a neonate with OEIS born by vertex spontaneous delivery to non-consanguineous parents. The major presenting defect was exstrophy of the cecum lying between two exstrophied halves of the bladder, an imperforate anus and spina bifida myelomeningocele. Explorative laparotomy revealed a duplex kidney system, attachment of the terminal ileum and cecum to the exstrophy, and a sausage-like atretic large bowel. Malrotation was also noted. Ladd's bands were released followed by ileostomy and ureterostomy. Patient was stable post-operatively and in the incubator on room air. OEIS remains a challenging anomaly that requires optimal treatment to facilitate the quality of life. With appropriate surgical intervention, the functional and social treatment goals for this unusual congenital defect can be met.

摘要

脐膨出-泄殖腔外翻-肛门闭锁-脊柱裂(OEIS)综合征是一种罕见的先天性疾病,涉及胃肠道、肌肉骨骼、肾脏、神经和泌尿生殖系统的缺陷。我们报告一例由非近亲父母自然分娩的患有OEIS综合征的新生儿病例。主要临床表现为盲肠外翻位于膀胱两外翻半侧之间、肛门闭锁和脊柱裂脊髓脊膜膨出。剖腹探查显示双肾系统、回肠末端和盲肠与泄殖腔外翻相连,以及腊肠样闭锁大肠。还发现了肠旋转不良。松解Ladd束,随后进行回肠造口术和输尿管造口术。术后患者情况稳定,在培养箱中呼吸室内空气。OEIS综合征仍然是一个具有挑战性的异常情况,需要最佳治疗以提高生活质量。通过适当的手术干预,可以实现这种罕见先天性缺陷的功能和社会治疗目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c916/10948741/f11dcef869c7/rjae166f1.jpg

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