Yanagihara J, Nakamura K, Shimotake T, Deguchi E, Iwai N
Division of Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine.
Eur J Pediatr Surg. 1995 Dec;5(6):372-4. doi: 10.1055/s-2008-1066247.
This is the first report of a 2-day-old girl having an association of biliary atresia and multiple intestinal atresia. She developed intractable vomiting in the first hours of life. An upper gastrointestinal series and barium enema showed jejunal atresia and rectal atresia. A laparotomy was performed on the fourth day of life. The operative findings were multiple sites of atresia of the intestine, 10 atretic sites in the small bowel, and 3 in the colon. The gall bladder was normal in size and position. After the operation, the patient's stool remained acholic and her jaundice did not resolve. On the 58th day of life, another laparotomy was performed with the presumptive diagnosis of biliary atresia. The operative finding was biliary atresia, type 3; the Kasai operation with external jejunostomy was performed. The patient suffered from postoperative cholangitis and enterocolitis because of her short bowel and subsequently died at 9 months of age. This is the first case of biliary atresia associated with multiple intestinal atresia reported in the literature.
这是关于一名2日龄女婴合并胆道闭锁和多处肠道闭锁的首例报告。她在出生后的最初几个小时出现顽固性呕吐。上消化道造影和钡剂灌肠显示空肠闭锁和直肠闭锁。在出生后第4天进行了剖腹手术。手术发现肠道多处闭锁,小肠有10处闭锁部位,结肠有3处。胆囊大小和位置正常。术后,患者的粪便仍无胆汁,黄疸也未消退。在出生后第58天,因初步诊断为胆道闭锁再次进行剖腹手术。手术发现为3型胆道闭锁;进行了Kasai手术并外置空肠造口术。由于小肠过短,患者术后发生胆管炎和小肠结肠炎,随后在9个月大时死亡。这是文献中报道的首例胆道闭锁合并多处肠道闭锁的病例。