Concomitant segmental intestinal dilatation and omphalocele (original) (raw)
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Journal of Neonatal Surgery, 2016
Congenital segmental dilatation (CSD) of the intestine is a rare developmental anomaly characterized by sharply demarcated dilatation of a gastrointestinal segment and may present with intestinal obstruction. We report three cases of CSD of the intestine in neonates with varied presentation. First patient was mistaken as pneumoperitoneum on abdominal radiograph, which led to initial abdominal drain placement. The 2nd patient was a case of anorectal malformation associated with congenital pouch colon (CPC) and CSD of ileum; and the third case presented as neonatal intestinal obstruction and found to have CSD of ileum. All the patients were successfully managed in our department.
Segmental ileal dilatation with supernumerary intestinal muscle coat in a neonate
Surgical Case Reports, 2015
Segmental intestinal dilatation (SID) is a rare developmental anomaly of the midgut, characterized by sharply demarcated dilatation of a gastrointestinal segment with clinical findings of intestinal obstruction. Although morphologic criteria for SID are clearly delineated, etiological origin of dilated intestine is unknown. Histology of the resected segment is usually reported to have normal presence of ganglion cells in the myenteric and submucosal plexuses. Intestinal muscle is hypertrophied, and heterotopic gastric mucosa may also be encountered. A 3-day-old male infant presenting with clinical findings of intestinal obstruction was diagnosed to have SID and had supernumerary intestinal muscle coat (SIMC) in the dilated segment, without any evidence of neurological abnormality. Histopathological findings of the resected ileal segment are reported to discuss the role of architectural malformation of muscularis propria as a cause of SID.
Neonatal intestinal obstruction due to absence of intestinal musculature: A new entity
Journal of Pediatric Surgery, 1967
ECENTLY, WE encountered a newborn with what we thought was meeonium ileus with meconium peritonitis which was unusual because both layers of the muscularis were congenitally absent in multiple large zones of the small intestine. A review of the literature failed to reveal a similar report. CASE REt'O~T A white male was born at 37 weeks of gestation after an uneventful pregnancy to a gravida IV, para III mother and on the first day of life, was noted to have a distended abdomen with prominent abdominal veins. Two other siblings died in infancy of multiple congenital anomalies but autopsy records were unobtainable. The baby was well-developed, well-nourished, conscious, irritable and in moderate distress. Birth weight was 2523 Gm. Bowel sounds were high pitched and the Madder was empty. Rectal examination revealed a patent rectum, and a rectal tube inserted 17 era. produced no meconium. Blood count revealed hemoglobin of 15.5 Gin. per cent with a normal retieulocyte count, red blood cells and hematocrit. Feedings of glucose water at 12 hours were followed by mild spitting. Milk was given on the second day and more regurgitation was observed. Abdominal distention persisted and vomiting of green, foul-smelling material began. A tap water enema with 1% hydrogen peroxide was given, with no results. Roentgenograms of the abdomen demonstrated small bowel obstruction with no gas in the colon. Electrolytes were within normal limits and CO~ content 23 mEq./L. A gastric tube was inserted and intravenous fluids were administered. At 52 hours, laparotomy showed a small intestine that looked like "one sausage attached to another" from the second portion of the duodenum to the cecum. Short lengths of normal appearing intestine followed distended intestine 13-15 em. in length and again the intestine was reduced to its normal caliber for 2-50 cm. (Fig. 1). The surgeon, unaware of the unusual pathology, attempted to resect all the distended portions of the small bowel segments without muscle and anastomose bowel of normal caliber. Five such connections were made. The baby tolerated this surgical procedure poorly. Cyanosis and shallow respirations did not respond to oxygen and he expired in the tenth post-operative hour. The surgical specimen consisted of 5 segments of small intestine (Fig. 1). The shortest measured 2 cm. in length by 1 cm. in diameter, and the longest was 50 cm. in length and 3 cm. in diameter. The serosa of all the segments was covered focally by fibrinous exudate. On opening, no area of complete obstruction was noted. The lumen contained thick, sticky, green meconium. The mueosa was congested with flattening of the folds in the dilated segment. Microscopically there was segmental absence of muscular layers (Fig, 2). The mucosa, lamina propria of the mucosa and submucosa were present and appeared normal. The outer-most portion of the submucosa was lined by mesothelial cells. The other segments contained all the layers of the intestine.
Pediatrics & Neonatology, 2013
obstruction; neonatal; prenatal diagnosis; segmental bowel dilatation Segmental dilatation of the intestine (SDI) is an unusual condition presenting during the neonatal period, with symptoms of obstruction. Late diagnosed cases are also reported. The clinical polymorphism, and the lack of specificity of radiological investigations, make diagnosis difficult. Prenatal detection of abdominal cystic lesions or bowel dilatation has occasionally been reported to be associated with SDI. We herein report two cases of SDI, with a prenatal ultrasonographic suspicion of intestinal abnormality. In both infants, a dilatation of the ileum was found at surgery, without any evident site of obstruction or abnormal histology. SDI must be taken into consideration when a prenatal alert of possible bowel obstruction is not followed by postnatal clinical signs.
Congenital Intestinal Obstruction
Textbook of Clinical Pediatrics, 2012
Table 418.1 Causes of neonatal intestinal obstruction Mechanical causes Functional causes Malrotation with midgut volvulus Prematurity Duodenal atresia Sepsis Annular pancreas Maternal narcotic use Jejunoileal atresia Magnesium use Colonic atresia Congenital hypothyroidism Meconium ileus Small left colon syndrome Anorectal malformation Meconium plug syndrome Presacral mass Hirschsprung's disease 4012 418 Congenital Intestinal Obstruction
Congenital segmental dilatation of the colon
Journal of Pediatric Surgery, 1982
Congenital segmental dilatation of the colon is a rare cause of intestinal obstruction in neonates. We report a case of congenital segmental dilatation of the colon and highlight the clinical, radiological, and histopathological features of this entity. Proper surgical treatment was initiated on the basis of preoperative radiological findings.