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Initial management of omphalocele using negative pressure wound therapy (NPWT) in Ecuador: A case series 厄瓜多尔负压伤口治疗脐膨出的初步治疗:一个病例系列
Q4 Medicine Pub Date : 2022-02-28 DOI: 10.47338/jns.v11.1046
Daniel Acosta-Farina, Johan Aguayo-Vistin, Cristhian Cedeño-Moreira, Vicente Salinas-Salinas, Verónica Polit-Guerrero, J. Oliveros-Rivero, Daniel Acosta-Bowen
Background: Omphalocele is an abdominal wall defect. Herniated organs can be small or large intestine, liver, and stomach. The use of conventional techniques has always been a challenge for the surgeon. The goal of using NPWT is to provide a quick, simple, and effective method to reduce the eviscerated content and enlarge the visceral continent.Case Presentation: The record of 3 patients with omphalocele was reviewed. There were two females and one male neonate. All the babies were born by C-section and were antenatally diagnosed for omphalocele. In all cases, NPWT was applied. Two cases were discharged in good condition while one patient with complex cardiac defects succumbed.Conclusion: NPWT is an effective and safe alternative for omphalocele management.
背景:脐膨出是一种腹壁缺损。疝出的器官可以是小肠、大肠、肝脏和胃。使用传统技术对外科医生来说一直是一个挑战。使用NPWT的目的是提供一种快速,简单,有效的方法来减少内脏内容和扩大内脏大陆。病例介绍:回顾了3例脐膨出的临床资料。有两名女性和一名男性新生儿。所有的婴儿都是剖腹产出生的,并在产前被诊断为脐膨出。在所有情况下,都采用了NPWT。2例出院情况良好,1例因复杂心脏缺陷死亡。结论:NPWT是一种安全有效的治疗脐膨出的方法。
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引用次数: 0
Congenital intrinsic duodenal obstruction: Clinical study and predictors of neonatal surgical mortality 先天性先天性十二指肠梗阻:新生儿手术死亡率的临床研究和预测因素
Q4 Medicine Pub Date : 2022-02-20 DOI: 10.47338/jns.v11.1034
Prmila Sharma, N. Pawar, Arun Gupta
Background: This study was aimed to analyze the clinical profile and the predictors of neonatal surgical mortality of congenital intrinsic duodenal obstruction (CIDO).Methods: This is a case series of 67 patients with CIDO (duodenal atresia and stenosis) admitted at our teaching institute, from October 2018 to June 2020. The demographic data, clinical presentation, diagnostic methods, location & type of duodenal atresia, the operative procedure performed, and neonatal surgical mortality (NSM) predictors such as birth weight, age on presentation, associated anomalies, duration of surgery, extubation after surgery, sepsis, and vasopressors support were analyzed.Results: Of 67 patients, 40(60%) were premature; mean weight and age at presentation were 2.06±0.6 (1-8 kg) and 6.7(1-240days), respectively. The majority of patients (59, 88%) presented with vomiting, and the most common finding on the x-ray abdomen was a double bubble sign (54, 81%). Twenty-four (36%) were associated with congenital heart disease and 19(28%) had Down’s syndrome. Type 3 duodenal atresia was the commonest finding in 43(64%) followed by type 1 in 22 (33%), and type 2 in 2(3%). In 49 (73%) Kimura’s duodenoduodenostomy, excision of web & duodenoplasty in 13 (19%), and side to side duodenoduodenostomy in 4 (6%), were performed. The mean hospital stay of survivors was 9 days. Overall survival was 63%.Conclusion: Type 3 duodenal atresia is the commonest variety observed. The prematurity, low birth weight, associated major congenital anomalies, surgery >90 minutes, delayed extubation after surgery, sepsis, and need for vasopressors support are significant predictors of NSM.
背景:本研究旨在分析先天性先天性十二指肠梗阻(CIDO)的临床特点和新生儿手术死亡率的预测因素。方法:这是一个病例系列,包括2018年10月至2020年6月在我们教学机构收治的67名CIDO(十二指肠闭锁和狭窄)患者。分析了人口统计学数据、临床表现、诊断方法、十二指肠闭锁的位置和类型、所进行的手术程序以及新生儿手术死亡率(NSM)预测因素,如出生体重、出现时的年龄、相关异常、手术持续时间、术后拔管、败血症和血管升压药支持。结果:67例患者中,早产40例(60%);平均体重和年龄分别为2.06±0.6(1-8kg)和6.7(1-240天)。大多数患者(59.88%)出现呕吐,腹部x光检查最常见的发现是双泡征(54.81%)。24人(36%)患有先天性心脏病,19人(28%)患有唐氏综合症。3型十二指肠闭锁43例(64%)最常见,其次是1型22例(33%)和2型2例(3%)。49例(73%)进行了Kimura十二指肠造口术,13例(19%)进行了腹板切除和十二指肠成形术,4例(6%)进行了侧十二指肠造口术。幸存者的平均住院时间为9天。总生存率为63%。结论:3型十二指肠闭锁是常见的十二指肠闭锁类型。早产、低出生体重、相关的重大先天性畸形、手术>90分钟、术后延迟拔管、败血症和需要血管升压药支持是NSM的重要预测因素。
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引用次数: 0
Starting from scratch: The primary hyperacidity theory of the cause of pyloric stenosis of infancy 从零开始:婴儿期幽门狭窄病因的原发性高酸性理论
Q4 Medicine Pub Date : 2022-01-14 DOI: 10.47338/jns.v11.1004
I. Rogers
The early observations of those who first described babies with pyloric stenosis (PS) are used as a backdrop for the development of the Inherited Primary Hyperacidity theory of cause. Those early truths, uncomplicated by modern technology, have acted as a springboard for pathogenesis. Hyperacidity, male predominance, family history, self-cure, enhanced appetite, and time-sensitive presentation were all well known to the early pioneers. Any system of pathogenesis must explain all these clinical features. The Inherited Primary Hyperacidity theory does this and is a credible explanation for all the clinical features established by these early pioneers. The evidence which supports a delay in maturation of the negative feedback between gastrin and gastric acidity is presented. Such a phenomenon further supports the Primary Hyperacidity theory.
最初描述婴儿幽门狭窄(PS)的人的早期观察结果被用作遗传原发性高酸度病因理论发展的背景。这些早期的真相,通过现代技术并不复杂,已经成为发病机制的跳板。高酸度、男性优势、家族史、自我治疗、食欲增强和对时间敏感的表现都是早期先驱所熟知的。任何一种发病机制都必须解释所有这些临床特征。继承的原发性高酸度理论做到了这一点,是对这些早期先驱建立的所有临床特征的可信解释。有证据支持胃泌素和胃酸之间负反馈的成熟延迟。这样的现象进一步支持了初级超酸性理论。
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引用次数: 0
Jejunal ectopic pancreas in a neonate 新生儿空肠异位胰腺
Q4 Medicine Pub Date : 2022-01-14 DOI: 10.47338/jns.v11.1031
Daniel Acosta-Farina, J. Oliveros-Rivero, Manuel Cabrera-Viteri, Vicente Salinas-Salinas, Daniel Acosta-Bowen
An 18-hour-old male newborn transferred from another medical center, born by emergency c-section performed due to previous c-section and amniotic fluid leakage (15 days). The baby was born at 40 weeks gestation with a birth weight of 2590 g, length of 49 cm, and APGAR scores of 7-9 at 1-5 min, respectively. Oxygen was administered through the nasal cannula due to difficulty in breathing. O2 saturation improved from 80 % to 92%. Dextrose bolus was used to correct hypoglycemia (32 mg/dl). The patient was hospitalized in the NICU.
一名从其他医疗中心转来的18小时男婴,因先前剖腹产和羊水漏而紧急剖腹产出生(15天)。婴儿于妊娠40周出生,出生体重2590 g,体长49 cm, 1-5分钟APGAR评分7-9分。由于呼吸困难,通过鼻插管给氧。氧饱和度从80%提高到92%。葡萄糖丸用于纠正低血糖(32mg /dl)。患者在新生儿重症监护室住院。
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引用次数: 0
Right retrocolic intrasaccular duodenum: Is it a novel variant of isolated duodenal nonrotation? A case report 右结肠后系囊内十二指肠:是孤立性十二指肠不旋转的新变种吗?病例报告
Q4 Medicine Pub Date : 2022-01-14 DOI: 10.47338/jns.v11.978
M. Huseynov
Background: Almost all of the studies on anomalies of the midgut rotation and fixation in the literature and related sections in textbooks were designed according to Dott's classification. Focusing only on common rotation anomalies has led to the exclusion and neglect of other rare variants. Isolated pure duodenal nonrotation is such a variant.Case Presentation: We report a case of an unusual form of isolated pure duodenal nonrotation, in a 3-day-old newborn presenting with bilious vomiting. Ultrasonographic examination revealed the sign of 'whirlpool'. When this finding was evaluated together with bilious vomiting, midgut volvulus was considered and the patient was operated on urgently. Peroperatively, it was observed that the jejunum entered between the leaves of the terminal ileum mesentery. Proximally, the duodenum was located posterior to the right colon in a "sack". This "sack" was surrounded by thick Ladd's bands laterally, mesentery of the ascending colon medially, the posterior surface of the cecum and ascending colon anteriorly, and by the posterior abdominal wall posteriorly.Conclusion: In isolated duodenal nonrotation, the duodenum may be completely retro-colic. Consequently, the duodenojejunal junction and the ileocecal region may almost overlap. Unlike isolated duodenal nonrotation cases, in the surgical treatment of this variant, separation of Ladd bands alone is not sufficient, additionally, the right colon should be placed in a nonrotation position and care should be taken not to kink the terminal ileum under the cecum.
背景:文献和教科书中有关章节中关于中肠旋转固定异常的研究几乎都是按照Dott分类设计的。只关注常见的旋转异常导致了其他罕见变异的排除和忽视。孤立的纯十二指肠不旋转就是这样一种变异。病例介绍:我们报告一个不寻常的形式孤立的纯十二指肠不旋转,在一个3天大的新生儿表现为胆汁性呕吐。超声检查显示“漩涡”征象。当这一发现与胆汁性呕吐一起评估时,考虑中肠扭转,并对患者进行紧急手术。术中观察到空肠进入回肠末端肠系膜叶之间。近端,十二指肠位于右结肠后方的“袋”内。这个“麻袋”外侧被厚的Ladd氏带包围,内侧是升结肠肠系膜,前部是盲肠和升结肠的后表面,后部是后腹壁。结论:在离体十二指肠不旋转时,十二指肠可能完全反绞痛。因此,十二指肠空肠交界处和回盲区可能几乎重叠。与孤立的十二指肠非旋转病例不同,在手术治疗中,仅分离Ladd条带是不够的,此外,应将右结肠置于非旋转位置,并注意不要将盲肠下的回肠末端缠绕。
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引用次数: 0
Burden and outcome of neonatal surgical conditions in Nigeria: A countrywide multicenter cohort study 尼日利亚新生儿外科手术的负担和结果:一项全国性多中心队列研究
Q4 Medicine Pub Date : 2022-01-09 DOI: 10.47338/jns.v11.1029
H. Ekwunife, E. Ameh, L. Abdur-rahman, Adesoji O. Ademuyiwa, Emem Akpanudo, F. Alakaloko
Background:  Despite a decreasing global neonatal mortality, the rate in sub-Saharan Africa is still high. The contribution and the burden of surgical illness to this high mortality rate have not been fully ascertained. This study is performed to determine the overall and disease-specific mortality and morbidity rates following neonatal surgeries; and the pre, intra, and post-operative factors affecting these outcomes. Methods: This was a prospective observational cohort study; a country-wide, multi-center observational study of neonatal surgeries in 17 tertiary hospitals in Nigeria. The participants were 304 neonates that had surgery within 28 days of life. The primary outcome measure was 30-day postoperative mortality and the secondary outcome measure was 30-day postoperative complication rates.Results: There were 200 (65.8%) boys and 104 (34.2%) girls, aged 1-28 days (mean of 12.1 ± 10.1 days) and 99(31.6%) were preterm. Sepsis was the most frequent major postoperative complication occurring in 97(32%) neonates. Others were surgical site infection (88, 29.2%) and malnutrition (76, 25.2%). Mortality occurred in 81 (26.6%) neonates. Case-specific mortalities were: gastroschisis (14, 58.3%), esophageal atresia (13, 56.5%) and intestinal atresia (25, 37.2%). Complications significantly correlated with 30-day mortality (p <0.05). The major risk predictors of mortality were apnea (OR=10.8), severe malnutrition (OR =6.9), sepsis (OR =7. I), deep surgical site infection (OR=3.5), and re-operation (OR=2.9). Conclusion: Neonatal surgical mortality is high at 26.2%. Significant mortality risk factors include prematurity, apnea, malnutrition, and sepsis.
背景:尽管全球新生儿死亡率在下降,但撒哈拉以南非洲的新生儿死亡率仍然很高。外科疾病对这一高死亡率的贡献和负担尚未完全确定。本研究旨在确定新生儿手术后的总体和疾病特异性死亡率和发病率;以及术前,术中,术后影响这些结果的因素。方法:这是一项前瞻性观察队列研究;尼日利亚17家三级医院新生儿手术的全国性多中心观察性研究。参与者是304名在28天内接受过手术的新生儿。主要结局指标为术后30天死亡率,次要结局指标为术后30天并发症发生率。结果:男婴200例(65.8%),女婴104例(34.2%),年龄1 ~ 28日龄(平均12.1±10.1日龄),早产99例(31.6%)。脓毒症是97例(32%)新生儿中最常见的主要术后并发症。手术部位感染(88例,29.2%)和营养不良(76例,25.2%)。81例(26.6%)新生儿死亡。病死率分别为胃裂伤(14例,58.3%)、食管闭锁(13例,56.5%)和肠闭锁(25例,37.2%)。并发症与30天死亡率显著相关(p <0.05)。死亡的主要危险预测因素为呼吸暂停(OR=10.8)、严重营养不良(OR= 6.9)、脓毒症(OR= 7)。I),深部手术部位感染(OR=3.5),再手术(OR=2.9)。结论:新生儿手术死亡率高达26.2%。重要的死亡危险因素包括早产、呼吸暂停、营养不良和败血症。
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引用次数: 3
The year 2021— Good for the surgical neonates in Pakistan 2021年——巴基斯坦新生儿手术顺利
Q4 Medicine Pub Date : 2021-12-31 DOI: 10.47338/jns.v10.1052
Bilal Mirza
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引用次数: 0
Neonatal intussusception secondary to intestinal duplication cyst: A case report 新生儿肠套叠继发于肠重复囊肿1例
Q4 Medicine Pub Date : 2021-11-24 DOI: 10.47338/jns.v10.999
Haseen Fathima, Divyangi Mishra, Nishanth Rajan, Joseph Manuel, M. Phansalkar, N. Zachariah
Background: Intussusception is a rare cause of bleeding per rectum in neonates. Duplication cyst as a pathological lead point for intussusception is rarer too.Case Presentation: A female neonate presented with bilious vomiting and bleeding per rectum. Ultrasonography diagnosed it as intussusception. Intraoperatively, on reduction of intussusception, a mass was found which on histopathological examination (HPE) revealed a duplication cyst.Conclusion: A high index of suspicion is required for an early diagnosis of neonatal intussusception, which is essential for preventing complications and mortality.
背景:肠套叠是新生儿直肠出血的罕见原因。重复囊肿作为肠套叠的病理先导点也比较少见。病例介绍:一名女性新生儿表现为胆汁性呕吐和直肠出血。超声诊断为肠套叠。术中,在肠套叠复位时发现一个肿块,组织病理学检查(HPE)显示为重复囊肿。结论:新生儿肠套叠的早期诊断需要高度的怀疑指数,对预防并发症和死亡率至关重要。
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引用次数: 0
Blueberry Muffin Syndrome 蓝莓松饼综合症
Q4 Medicine Pub Date : 2021-10-23 DOI: 10.47338/jns.v10.1028
Rahul Gupta
{"title":"Blueberry Muffin Syndrome","authors":"Rahul Gupta","doi":"10.47338/jns.v10.1028","DOIUrl":"https://doi.org/10.47338/jns.v10.1028","url":null,"abstract":"","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43383168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility of primary anastomosis for right-sided colonic atresia: A case report 一期吻合治疗右侧结肠闭锁的可行性1例
Q4 Medicine Pub Date : 2021-10-19 DOI: 10.47338/jns.v10.950
Muhammad Shamil Suhaimi, M. Y. Othman, Khalilah Alhuda Binti Kamilen
Background: Colonic atresia (CA) is a rare cause of congenital intestinal obstruction. The management of CA is challenging because of its rarity.Case Presentation: We present a case of right-sided CA in a term male baby weighing 3006 gm, without any other comorbidity. Type 1 atresia was seen at ascending colon and upon decompression, a reasonable caliber was achieved for a primary anastomosis following distal Cheatle slit and proximal tapering. Postoperative recovery was uneventful.Conclusion: Primary anastomosis is a feasible option in right-sided CA when no major comorbidity is present and a normal distal colon with reasonable caliber is certain.
背景:结肠闭锁是一种罕见的先天性肠梗阻。CA的管理由于其稀有性而具有挑战性。病例介绍:我们报告一例体重3006克的足月男婴右侧CA,无其他合并症。1型闭锁见于升结肠,减压后,在远端Cheatle切口和近端逐渐变细后进行初级吻合,达到了合理的口径。术后恢复顺利。结论:在无重大合并症且远端结肠正常、口径合理的情况下,一期吻合是右侧CA的可行选择。
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引用次数: 0
期刊
Journal of Neonatal Surgery
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