A Case of Idiopathic Diffuse Pneumoperitoneum Presented with Neonatal Abdominal Color Change

S. Akar, Mehmet Göksu
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Abstract

Background: Necrotizing enterocolitis is the leading cause of intestinal perforation and pneumoperitoneum in neonates. In addition, neonatal pneumoperitoneum includes several conditions requiring surgery, such as gastric and duodenal perforation, intestinal atresia, volvulus, meconium ileus, and Hirschsprung’s disease. A type of pneumoperitoneum in which intra-abdominal free air is detected through direct X-ray; however, no cause is found clinically and radiologically during the surgery is named “benign pneumoperitoneum”. Case report: This case report presents a 5-day-old male newborn who is presented with complaints of abdominal color change and vomiting and is diagnosed with Idiopathic Benign Pneumoperitoneum (IBP) during the operation. Neonatal pneumoperitoneum usually occurs as a result of perforation and requires emergency surgery. Rare cases of IBP should also be kept in mind. Unnecessary surgery can be prevented by establishing a differential diagnosis with clinical, laboratory, and imaging methods.   Conclusion: This case demonstrated that laparotomy is not a true routine in neonates with IBP if a timely diagnosis is established.
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新生儿腹部颜色改变的特发性弥漫性气腹1例
背景:坏死性小肠结肠炎是新生儿肠穿孔和气腹的主要原因。此外,新生儿气腹包括一些需要手术的情况,如胃和十二指肠穿孔、肠闭锁、肠扭转、粪便肠梗阻和先天性巨结肠病。一种通过x射线直接检测腹腔内自由空气的气腹;然而,在临床和放射学上没有发现病因的手术被命名为“良性气腹”。病例报告:这个病例报告了一个5天大的男婴,他以腹部颜色改变和呕吐为主诉,在手术中被诊断为特发性良性气腹(IBP)。新生儿气腹通常是穿孔的结果,需要紧急手术。罕见的IBP病例也应铭记在心。通过临床、实验室和影像学方法的鉴别诊断,可以避免不必要的手术。结论:本病例表明,如果及时诊断,剖腹手术并不是IBP新生儿的常规治疗方法。
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