Wu Yan-Jun, Hsu Kai-Hsiang, Lai Jin-Yao, Hsu Jen-Fu
Department of Pediatrics, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.
Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan.
Surg Case Rep. 2025;11(1). doi: 10.70352/scrj.cr.25-0294. Epub 2025 Jul 15.
Omphalocele is a congenital abdominal wall defect that is characterized by herniation of the abdominal viscera through the umbilical ring. Compared with gastroschisis, omphalocele is less frequently associated with ileal atresia. This report describes a preterm newborn with a minor omphalocele complicated by ileal atresia, a complication that may have been previously underestimated.
A 5-day-old preterm male infant (gestational age 34 weeks, birth weight 2005 g) presented with delayed meconium passage and persistent bilious gastric aspirates. Antenatal ultrasound revealed an umbilical cyst without any other anomalies. On day 4, a gastrointestinal series examination revealed dilated small bowel loops and a small-caliber colon. Surgical exploration revealed bowel contents entrapped within a 2.2-cm minor omphalocele. The infant was diagnosed with type IIIa distal ileal atresia and colonic atresia, and end-to-end anastomosis was performed. The patient was discharged at a corrected age of 6 weeks on a hypoallergenic semi-elemental formula (50 mL per meal) and partial parenteral nutrition. He was successfully weaned off parenteral nutrition by a corrected age of approximately 10 months. His weight gain was stable, although it remained at approximately the 3rd percentile, and no obvious neurodevelopmental complications were observed.
This case highlights the importance of recognizing that even minor omphaloceles can be associated with ileal atresia. In neonates with minor omphaloceles, symptoms of feeding intolerance should prompt consideration of this complication.
脐膨出是一种先天性腹壁缺陷，其特征是腹腔内脏器通过脐环疝出。与腹裂相比，脐膨出较少合并回肠闭锁。本报告描述了一名患有轻度脐膨出并合并回肠闭锁的早产儿，这种并发症可能此前被低估了。
一名5日龄的早产男婴（胎龄34周，出生体重2005克），出现胎粪排出延迟和持续胆汁性胃抽出物。产前超声显示有一个脐部囊肿，无其他异常。第4天，胃肠道造影检查显示小肠袢扩张和结肠管径变细。手术探查发现肠内容物被困在一个2.2厘米的轻度脐膨出内。该婴儿被诊断为IIIa型远端回肠闭锁和结肠闭锁，并进行了端端吻合术。患儿在矫正年龄6周时出院，采用低敏半要素配方奶（每餐50毫升）和部分肠外营养。在矫正年龄约10个月时，他成功停用了肠外营养。他的体重增长稳定，尽管仍处于约第3百分位，且未观察到明显的神经发育并发症。
本病例强调了认识到即使是轻度脐膨出也可能合并回肠闭锁的重要性。在患有轻度脐膨出的新生儿中，喂养不耐受的症状应促使考虑这种并发症。
