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neonate gut perforated

Barrie S Rich, Stephen E Dolgin
Necrotizing enterocolitis (NEC) is a frequently encountered condition in the premature neonate, which can have devastating effects. The signs and symptoms of NEC are variable and can be confused with those of sepsis. An abdominal radiograph is often obtained for diagnosis, and findings that indicate NEC include pneumatosis and portal venous gas. The treatment of NEC includes gastrointestinal rest, gastric decompression, broad-spectrum intravenous antibiotics, and systemic support. A finding of pneumoperitoneum signifies intestinal perforation, which requires surgical intervention...
December 2017: Pediatrics in Review
Praveen Kumar Ravi, Manisha Rajanand Gaikwad, Pravash Ranjan Mishra, Naina Santosh Wakode, Prabhas Ranjan Tripathy, E Tripati Patro, Babita Kujur, Santosh Laxman Wakode
Midgut malrotation and incomplete rotation are common causes of neonatal intestinal obstruction. At end of 10 week of intrauterine life, cecum will be placed in subhepatic region temporarily and descends to right lower quadrant by eleventh week. Arrest of cecum in subhepatic region or undescended cecum is a rare congenital anomaly of mid gut. Usually, it remains asymptomatic and is diagnosed incidentally. If any pathology occurs in anomalous part, like appendicitis then the diagnosis and treatment will be challenging in all age groups...
September 2017: Anatomy & Cell Biology
Anna Tarko, Anna Suchojad, Marta Michalec, Małgorzata Majcherczyk, Aniceta Brzozowska, Iwona Maruniak-Chudek
INTRODUCTION: Zonulin (ZO), a new diagnostic biomarker of intestinal permeability, was tested in newborns presenting symptoms of infection and/or inflammation of the gut or being at risk of intestinal pathology. MATERIAL AND METHODS: Serum ZO was assessed in 81 newborns diagnosed with sepsis, necrotizing enterocolitis (NEC), rotavirus infection, and gastroschisis, also in extremely low gestational age babies, and in controls (healthy newborns). ZO concentration was compared to C-reactive protein (CRP) and procalcitonin (PCT) values, leucocyte and platelet count, basic demographic data, and the value of the Neonatal Therapeutic Intervention Scoring System (NTISS)...
2017: Disease Markers
Hemanshoo Sudhir Thakkar, Kokila Lakhoo
Necrotising enterocolitis (NEC) is a neonatal surgical emergency. At its early stages, the management of NEC is largely medical using broad-spectrum antibiotics, gut rest and total parental nutrition. The only absolute indication for surgery is an intra-abdominal perforation. There are several relative indications for surgery based on clinical, biochemical and radiological parameters. Once the decision to intervene is made, several approaches may be taken. Peritoneal lavage can be used as a salvage procedure or definitive management in some cases...
June 2016: Early Human Development
Lindsey E Romick-Rosendale, Kurt R Schibler, Michael A Kennedy
BACKGROUND: Currently used biomarkers for acute kidney injury (AKI), namely Ngal, SCr, and BUN, are inadequate for timely detection of AKI in preterm infants. METHODS: Nuclear magnetic resonance (NMR) spectroscopy-based metabolic profiling was conducted on urines from 20 preterm infants to determine if novel metabolic biomarkers could be identified for early detection of AKI. Urines were collected from every patient each day for the first 14 days of life. NMR spectra were measured for all urines and metabolic profiling analysis conducted...
February 2012: Journal of Molecular Biomarkers & Diagnosis
F Cáceres, D Franco, J Arboleda, P Cuesta, E Hidalgo, P Astudillo
INTRODUCTION: Despite advances in neonatal care between 20% and 63% of children with necrotizing enterocolitis (NEC) require surgery. The aim was correlation the risk factors of infants with NEC "IIB / IIIA / IIIB" Bell and the clinical, surgical and pathological findings. METHOD: In the children with diagnosis of NEC surgically treated, were analyzed of variables: clinical, surgical and pathological findings. We studied two groups: control (n=5) and NEC group (n=12)...
August 2011: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Arshad Kamal, Kifayat Khan, Inayat ur Rahman, Ayub Khan
BACKGROUND: Small gut atresia is a common neonatal surgical problem. Early diagnosis and timely management of the neonate can reduce mortality and morbidity in these patients. The aim of this study was to note the causes of mortality and morbidity in these neonates. METHODS: This was a prospective study conducted at Lady Reading Hospital (LRH) Peshawar from August 2007 to August 2009. All patients with small gut atresia were included in this study. Neonates having intestinal obstruction due to another cause were excluded from this study...
April 2010: Journal of Ayub Medical College, Abbottabad: JAMC
F Bartoli, S Vasseur Maurer, E Giannoni, M-C Osterheld, B Laubscher
Two cases of neonatal focal spontaneous colic perforations are reported. The 1st infant, born at 36 3/7 weeks gestational age, presented on day 3 with crying, abdominal distension, and liquid stools. Clinical examination showed a slightly irritable hypothermic (35.7 °C) infant with a distended abdomen and few bowel sounds. Blood tests were normal apart from an elevated C-reactive protein level (59 mg/l). The abdomen x-ray was erroneously considered normal. The infant's condition remained stable for nearly 3 days...
April 2011: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
R Sharma, M L Hudak, J J Tepas, P S Wludyka, R-J Teng, L K Hastings, W H Renfro, W J Marvin
OBJECTIVE: To examine the role of indomethacin in neonatal gut injury. STUDY DESIGN: Infants born at gestational age 23 weeks and with birth weights 400-1200 g were included in this prospective prevalence study of neonatal gut injury. Infants with isolated intestinal perforation (IIP) confirmed at laparotomy or at autopsy or with necrotizing enterocolitis (NEC) were identified. Data were abstracted bi-weekly. RESULT: Among 992 study infants, 58 infants exposed solely to prenatal indomethacin did not show an increased rate of neonatal gut injury...
December 2010: Journal of Perinatology: Official Journal of the California Perinatal Association
Osarumwense David Osifo, Jonathan Chukwunalu Okolo
BACKGROUND: Intestinal obstruction is a life threatening condition in the newborn, with attendant high mortality rate especially in underserved subregion. This study reports the aetiology, presentation, and outcome of intestinal obstruction management in neonates. MATERIALS AND METHODS: A prospective study of neonatal intestinal obstruction at the University of Benin Teaching Hospital, Benin, Nigeria, between January 2006-June 2008. Data were collated on a structured proforma and analysed for age, sex, weight, presentation, type/date of gestation/delivery, aetiology, clinical presentation, associated anomaly, treatment, and outcome...
July 2009: African Journal of Paediatric Surgery: AJPS
Kamalesh Pal, Hamdi Ashri, Ayman A Madani
Ectopic pancreatic tissues of the gut are usually found incidentally during laparotomy or are reported in the autopsy findings. Rarely these ectopic pancreatic tissues may cause symptoms such as hemorrhage, pancreatitis, intussusception or perforation. We present a case report of the presence of multiple ectopic pancreatic tissues in the gut causing hemorrhage and perforation in a preterm, extremely low birth weight neonate with multiple congenital anomalies.
April 2008: Saudi Medical Journal
M Rygl, K Pycha, Z Stranak, R Skaba, R Brabec, V Cunat, J Snajdauf
To evaluate the results of use of T-tube ileostomy in selected cases of intestinal perforation in extremely low birth weight (ELBW) neonates. The records of 288 ELBW neonates treated at author's institution, from 1998 to 2003 were retrospectively reviewed to identify neonates operated for intestinal perforation with T-tube placement. T-tube was inserted into the bowel through the site of perforation or proximally to the perforated gut via separate stab incision. T-tubes were used in five ELBW neonates (BW 600-900 g, gestational age 25-27 weeks) with intestinal perforation, in four of them at the time of primary surgery and in one neonate 8 days after primary anastomosis...
July 2007: Pediatric Surgery International
R A Bellows, D J Patterson, P J Burfening, D A Phelps
Results are summarized of necropsy findings from 798 calves lost from birth to weaning over a 15-yr period. Autopsies determined cause of death and ascertained anatomical normalcy of the skeletal, musculature and organ systems and functinal status of the lungs. Of the 798 calves, 77.7% were anatomically normal and 22.3% were abnormal (P < 0.01) and 75.0% of the total deaths of abnormal calves occurred by Day 2 postpartum. Birth weights of normal calves averaged 4.2 kg heavier (P < 0.05) than that of abnormal calves...
November 1987: Theriogenology
S S Shah, A Ohlsson
BACKGROUND: A patent ductus arteriosus (PDA) often complicates the clinical course of preterm infants and increases the risk of intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), chronic lung disease (CLD) and death. The standard treatment to close a PDA is indomethacin. Its use is associated with renal, gastrointestinal and cerebral side-effects. Ibuprofen has been shown to be effective in closing a PDA without reducing blood flow velocity to the brain, gut or kidneys...
2006: Cochrane Database of Systematic Reviews
Josef Neu
Necrotizing enterocolitis (NEC) is a leading cause of mortality and morbidity in neonatal intensive care units. Here we review selected manifestations of NEC, risk factors involved in its pathophysiology as well as putative mechanisms associated with how an immature gut might be more susceptible to NEC. Treatment and potential preventive strategies are discussed.
October 2005: Acta Paediatrica. Supplement
Renu Sharma, Joseph J Tepas, Mark L Hudak, Pam Pieper, Ru-Jeng Teng, Savithri Raja, Monica Sharma
Infectious burden of gut injury (G-INJ) associated with necrotizing enterocolitis (NEC) or with spontaneous intestinal perforation (SIP) in neonates has not been ascertained. We sought to test the hypotheses that: (1) infants with G-INJ develop higher number of infections including non-concurrent infections than infants without G-INJ in a neonatal intensive care unit (NICU); (2) surgical debridement (DEB) of infants with severe G-INJ is associated with lower infectious morbidity and mortality. All infants admitted to the regional NICU from October 1991 to February 2003 were included in this prospective prevalence investigation of G-INJ and infections...
December 2005: Pediatric Surgery International
N Kalfa, C Zamfir, M Lopez, D Forgues, O Raux, M P Guibal, R B Galifer, H Allal
BACKGROUND: This study aimed to evaluate the optimal conditions for laparoscopic management of neonatal subacute volvulus with malrotation. METHODS: Between 1994 and 2002, 13 neonates with midgut volvulus and malrotation entered the authors' institution. Five of these neonates met the eligibility criteria for laparoscopy: good hemodynamic parameters, no gut perforation, and no severe ischemic distress of the bowel shown on preoperative ultrasonography. RESULTS: The results were excellent for only three infants, associated with a shorter postoperative course...
December 2004: Surgical Endoscopy
Shyam B Sharma, Vipul Gupta, Vinod Sharma
We describe the presentation and management of gastrointestinal perforation in four neonates with anorectal malformations. Two neonates with high malformation had pneumoperitoneum on X-ray; surgery revealed sigmoid perforation in one patient and transverse colon perforation in the other. Colostomy was done, followed by posterior sagittal anorectoplasty at four months; both recovered satisfactorily. The third neonate had no radiological feature of gut perforation but cecal perforation was found at surgery; the neonate recovered following right hemicolectomy with stoma followed by anorectoplasty at five months...
May 2004: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Andrew C Herman, Erica M Carlisle, Jessica B Paxton, Phillip V Gordon
Spontaneous intestinal perforations in extremely premature infants are associated with glucocorticoid-induced thinning of the ileal bowel wall. We have previously demonstrated that insulin-like growth factor-1 (IGF-1) is abundant within the submucosa of the newborn mouse ileum but is diminished by glucocorticoid exposure, concomitant with bowel wall thinning. These findings prompted us to hypothesize that IGF-I governs submucosal growth during neonatal gut development and that diminished IGF-I abundance results in submucosal thinning...
March 2004: Pediatric Research
M W Davies, R M Kimble, P G Woodgate
BACKGROUND: Gastroschisis is a congenital anterior abdominal wall defect with the abdominal contents protruding through the defect. Reduction of the abdominal contents is required within hours after birth as the infant is at risk not only of water and heat loss from the exposed bowel but also of compromised gut circulation with ischaemia and infarction. To avoid the complications of general anaesthetic and mechanical ventilation it has been proposed that the reduction of abdominal contents can be achieved without endotracheal intubation or anaesthesia...
2002: Cochrane Database of Systematic Reviews
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