Clinical variants of abdominal surgical pathology in premature infants

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Abstract

Introduction. In the majority of cases, acute abdominal pathology in premature newborns masks as necrotizing enterocolitis and, if there are no signs of intestinal perforation, conservative therapy is prescribed. The article discusses rare forms of acute surgical pathology in premature newborns.

Clinical observations. In the first clinical case, a premature baby had an initial air leak syndrome (pneumothorax and pneumoperitoneum). The Meckel’s diverticulitis with perforation without peritonitis was found during surgery. In the second case, a newborn child with body weight 1160 grams on the 21st day of his life developed ileoileal intussusception. In the third case, a newborn child had the duodenal membrane which was excised on the 5th day of life. On the 11th postoperative day, a picture of perforated hollow organ in the abdominal cavity developed. Destructive appendicitis was found intra-operatively. All patients clinically recovered.

Conclusion. Ultrasound examination, as an early diagnostic option, can help to suspect a surgical pathology at an early stage. The described clinical cases are rare in pediatric surgeon’s practice but they require a cautious approach from both narrow clinical specialists and diagnostic specialists.

About the authors

Yu. Yu. Koynov

Novosibirsk State Regional Clinical Hospital

Author for correspondence.
Email: doctor2012@inbox.ru
ORCID iD: 0000-0002-9528-0601

Yuri Y. Koynov, pediatric surgeon of pediatric department

630087 Novosibirsk

Россия

A. V. Gramzin

Novosibirsk State Regional Clinical Hospital;
Novosibirsk State Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0001-7338-7275
630087 Novosibirsk;  
630091 Novosibirsk Россия

N. V. Krivosheenko

Novosibirsk State Regional Clinical Hospital

Email: fake@neicon.ru
ORCID iD: 0000-0001-6210-7493
630087 Novosibirsk Россия

P. M. Pavlushin

Novosibirsk State Regional Clinical Hospital

Email: fake@neicon.ru
ORCID iD: 0000-0002-6684-5423
630087 Novosibirsk Россия

V. N. Tsyganok

Novosibirsk State Regional Clinical Hospital

Email: fake@neicon.ru
ORCID iD: 0000-0003-1176-6741
630087 Novosibirsk Россия

Yu. V. Chikinev

Novosibirsk State Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0002-6795-6678
630091 Novosibirsk Россия

References

  1. Подкаменев В.В. Патология дивертикула Меккеля у детей. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2012; 2(4): 28-33.
  2. Гераськин А.В., Смирнов А.Н., Дронов А.Ф. и cоавт. Патология дивертикула Меккеля: современный подход к диагностике и лечению. Анналы хирургии.1997; 2: 21-8.
  3. Ольхова Е.Б., Карцева Е.В., Кузнецова Е.В., Кирсанов А.С., Дземешко Е.В. Острый аппендицит у новорожденного (клиническое наблюдение). Радиология-практика. 2015; 3: 54-9.
  4. Gullen J.J., Kelly K.A., Moir C.R..Surgical management of Meckel’s diverticulum. An epidemiologic population based study. Ann. Surg. 1994; 220: 564-9.
  5. St-Vil D., Brandt M.L., Panic S., Bensoussan A., Blanchard H. Meckel’s diverticulum in children: A 20-year review. Journal of Pediatric Surgery. 1991; 26(11): 1289–92.
  6. Gaisie G., Curnes J.T., ScatliÄ J.H. et al. Neonatal intestinal obstruction from omphalomesenteric duct remnants. Am. J. Radiol. 1985; 144: 109-12.
  7. Brown R. L., Azizkhan R. G. Gastrointestinal bleeding in infants and children: Meckel's diverticulum and intestinal duplication. Seminars in Pediatric surgery. WB Saunders. 1999; 8(4): 202-9.
  8. Valla J.S., Steyaert H., Leculee R. et al. Meckel’s diverticulum and laparoscopy of children. What’s new? Eur. J. Pediatr. Surg. 1998; 8: 26-8.
  9. Gandy, J., Byrne, P., & Lees, G. Neonatal Meckel’s diverticular inflammation with perforation. Journal of Pediatric Surgery. 1997; 32(5): 750–1.
  10. Mooney D.P., Steinthorsson G., Shorter N. A. Perinatal intussusception in premature infants. Journal of pediatric surgery.1996; 31(5): 695-7.
  11. Ayoub B.H., Omran Y., Hassan A., Hindi S. The importance of timely detection and management in neonatal appendicitis. BMJ Case Rep. 2014; 22: 2014.
  12. Malakounides G., John M., Rex D., Mulhall J. Nandi B., Mukhtar Z. Laparoscopic surgery for acute neonatal appendicitis. Pediatr. Surg. Int. 2011; 27(11): 1245–8.
  13. Miyamoto K., Furuta Y., Mukai S. Omphalomesenteric duct remnants: a review of 12 cases. J. Jpn. Soc. Pediatr. Surg. 1986; 23: 1048-56.
  14. Schwartz K.L., Gilad E., Sigalet D., Yu W., Wong A.L. Neonatal acute appendicitis: a proposed algorithm for timely diagnosis. Journal of Pediatric Surgery. 2011; 46(11): 2060–4.
  15. Bannister S.L., Wong A.L., Leung A.K. Acute appendicitis in an incarcerated inguinal hernia. J. Natl. Med. Assoc. 2001; 93(12): 487-9.
  16. Sarioglu A., Tanyel F.C., Büyükpamukçu N., et al. Appendiceal perforation: a potentially lethal initial mode of presentation of Hirschsprung's disease. J. Pediatr. Surg. 1997; 32(1): 123-4.
  17. Karaman A., Cavusoglu Y.H., Karaman I., et al. Seven cases of neonatal appendicitis with a review of the English language literature of the last century. Pediatr. Surg. Int. 2003; 19(11): 707-9.
  18. Jahangiri M., Hosseinpour M., Jazayeri H., Mohammadzadeh M., Motaharizad D., Mirzadeh A. S. Perforated acute appendicitisin a pre-term neonate. Iran. Red. Crescent. Med. J. 2013; 15(6): 497–9.
  19. Stiefel D., Stallmach T., Sacher P. Acute appendicitis in neonates: complication or morbus sui generis? Pediatr. Sur.g Int. 1998;14(1-2): 122-3.
  20. Fanaroff A.A., Stoll B.J.,Wright L.L., Carlo W.A. Trends in neonatal morbidity and mortality for very low birthweight infants. Am. J. Obset. Gynecol. 2007; 196:147.
  21. Arliss J., Holgersen L.O. Neonatal appendiceal perforation and Hirschsprung’s disease. J Pediatr. Surg. 1990; 25(6): 694-5.
  22. Wright J.E., Bhagwandon S.B. Antenatal perforation of Meckel’s diverticulum presenting as an inflamed hydrocele. Journal of Pediatric Surgery. 1986; 21(11): 989–90.
  23. Saxena R., Puri A., Pinnamaneni R. Waugh syndrome in preterm infant: diagnostic clues. Pediatrics & Neonatology. 2015; 56(3): 203-4.
  24. Efrati Y., Peer A., Klin B., et al. Neonatal periappendicular abscess – updated treatment. J Pediatr. Surg. 2003; 38(2): 5.
  25. Buntain WL. Neonatal appendicitis mistaken for necrotizing enterocolitis. South. Med. J. 1982; 75(9): 1155.
  26. Shad J., Biswas R. Ileo-colic intussusception in premature neonate. BMJ Case Reports. 2011; 10: 1136
  27. Smith V.S., Giacoia G.P. Intussusception associated with necrotizing enterocolitis. Clinical pediatrics journal.1984; 23(1): 43-5.
  28. Epelman M., Daneman A., Navarro O.M., et al. Necrotizing enterocolitis: review of state-of-the-art imaging findings with pathologic correlation. Radiographics. 2007; 27(2): 285-305.
  29. Aydin E. Intussusception in a preterm newborn. Pediatrics & Neonatology. 2018; 59(30): 312-4.
  30. Avansino J.R. et al. Clinical features and treatment outcome of intussusception in premature neonates. Journal of pediatric surgery. 2003; 38(12): 1818-21.
  31. Ueki I. et al. Intussusception in neonates: analysis of 14 Japanese patients. Journal of paediatrics and child health. 2004; 40(7): 388-91.
  32. Wang N.L. et al. Prenatal and neonatal intussusception. Pediatric surgery international. 1998; 13(4): 232-6.
  33. Tepmalai K. et al. Intussusception in premature baby: unusual cause of bowel obstruction and perforation. Journal of neonatal surgery. 2017; 6(1).
  34. Lodha A., Wales P.W., James A., et al. Acute appendicitis with fulminant necrotizing fasciitis in a neonate. J Pediatr. Surg. 2003; 38(11): E5-6.
  35. Joshi S.B., Kinhal V., Desai M., Tilak, Choudhari F.U. A rare case of jejunal atresia due to intrauterine intussusception. J. Clin. Diag. Res. 2015; 9: 30.
  36. Shima Y. et al. Intussusception in an extremely premature infant following bacterial sepsis. European journal of pediatrics. 2012; 171(4): 725-7.
  37. Görgen-Pauly U. et al. Intussusception in preterm infants: case report and literature review. European journal of pediatrics. 1999; 15(10): 830-2.
  38. Miller S.F. The impact of imaging in the management of intussusception owing to pathologic lead points in children. A review of 43 cases. Radiology. 1995; 197: 493-6.
  39. Loukas I. et al. Intussusception in a premature neonate: A rare often misdiagnosed cause of intestinal obstruction. Case reports in medicine. 2009; 2009: 3.

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