在内脏穿孔的早产儿中,越来越多的人认识到肠道肌肉节段性缺失:病例系列

Carolina Pinzon-Guzman , Alexander Kevorkov , Karl Grenier , Maeve O'Neill Trudeau , Pramod Puligandla , Etienne St-Louis
{"title":"在内脏穿孔的早产儿中,越来越多的人认识到肠道肌肉节段性缺失:病例系列","authors":"Carolina Pinzon-Guzman ,&nbsp;Alexander Kevorkov ,&nbsp;Karl Grenier ,&nbsp;Maeve O'Neill Trudeau ,&nbsp;Pramod Puligandla ,&nbsp;Etienne St-Louis","doi":"10.1016/j.epsc.2024.102915","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Segmental absence of intestinal musculature (SAIM) is a pathological diagnosis, denoting focal absence of the muscularis propria in the presence of intact surrounding structures. This condition often presents as spontaneous intestinal perforation (SIP) and can be difficult to distinguish clinically from necrotizing enterocolitis (NEC).</div></div><div><h3>Case presentations</h3><div>We present 5 cases of premature babies with gestational age ranging from 24 + 3 weeks up to 32 + 1 weeks, who all presented with intestinal perforation before the 15th day of life. Three patients presented with a distended abdomen and discoloration and were subsequently found to have pneumoperitoneum on abdominal x-ray (AXR). The 2 other patients presented with clinical deterioration but without signs of intestinal perforation and were subsequently found to have pneumoperitoneum on AXR. All underwent bowel resection of perforated bowel with either ileostomy with mucous fistula or primary end-to-end anastomosis. Two patients required repeat exploratory laparotomies within a week of their initial surgery due to pneumoperitoneum in subsequent AXR caused by new perforations in other parts of the small bowel. One patient sustained an iatrogenic liver injury intra-operatively and passed away 1 day post-operatively. All patients were found to have SAIM on histopathological examination.</div></div><div><h3>Conclusion</h3><div>SAIM is a pathological diagnosis that can manifest as SIP and may denote a risk for recurrent peritonitis in premature infants who underwent bowel resection for perforated viscus without a clear etiology.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102915"},"PeriodicalIF":0.2000,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Segmental absence of intestinal musculature increasingly recognized in premature infants with perforated viscus: A case series\",\"authors\":\"Carolina Pinzon-Guzman ,&nbsp;Alexander Kevorkov ,&nbsp;Karl Grenier ,&nbsp;Maeve O'Neill Trudeau ,&nbsp;Pramod Puligandla ,&nbsp;Etienne St-Louis\",\"doi\":\"10.1016/j.epsc.2024.102915\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Segmental absence of intestinal musculature (SAIM) is a pathological diagnosis, denoting focal absence of the muscularis propria in the presence of intact surrounding structures. This condition often presents as spontaneous intestinal perforation (SIP) and can be difficult to distinguish clinically from necrotizing enterocolitis (NEC).</div></div><div><h3>Case presentations</h3><div>We present 5 cases of premature babies with gestational age ranging from 24 + 3 weeks up to 32 + 1 weeks, who all presented with intestinal perforation before the 15th day of life. Three patients presented with a distended abdomen and discoloration and were subsequently found to have pneumoperitoneum on abdominal x-ray (AXR). The 2 other patients presented with clinical deterioration but without signs of intestinal perforation and were subsequently found to have pneumoperitoneum on AXR. All underwent bowel resection of perforated bowel with either ileostomy with mucous fistula or primary end-to-end anastomosis. Two patients required repeat exploratory laparotomies within a week of their initial surgery due to pneumoperitoneum in subsequent AXR caused by new perforations in other parts of the small bowel. One patient sustained an iatrogenic liver injury intra-operatively and passed away 1 day post-operatively. All patients were found to have SAIM on histopathological examination.</div></div><div><h3>Conclusion</h3><div>SAIM is a pathological diagnosis that can manifest as SIP and may denote a risk for recurrent peritonitis in premature infants who underwent bowel resection for perforated viscus without a clear etiology.</div></div>\",\"PeriodicalId\":45641,\"journal\":{\"name\":\"Journal of Pediatric Surgery Case Reports\",\"volume\":\"111 \",\"pages\":\"Article 102915\"},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2024-10-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatric Surgery Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S221357662400143X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Surgery Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S221357662400143X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0

摘要

导言肠道肌肉组织节段性缺失(SAIM)是一种病理诊断,表示在周围结构完好的情况下,固有肌的局灶性缺失。这种情况通常表现为自发性肠穿孔(SIP),临床上很难将其与坏死性小肠结肠炎(NEC)区分开来。病例介绍我们介绍了 5 例早产儿,胎龄从 24+3 周到 32+1 周不等,他们都在出生后第 15 天前出现肠穿孔。其中 3 名患者出现腹部膨胀和变色,随后在腹部 X 光检查(AXR)中发现腹腔积气。另外两名患者临床症状恶化,但没有肠穿孔迹象,随后在腹部X光检查中发现腹腔积气。所有患者都接受了穿孔肠道切除术,并进行了回肠造口术和粘液瘘或原发性端端吻合术。两名患者在首次手术后一周内因小肠其他部位的新穿孔导致腹腔积气而需要再次进行剖腹探查手术。一名患者在术中出现先天性肝损伤,术后 1 天去世。结论 SAIM 是一种病理诊断,可表现为 SIP,可能意味着因内脏穿孔而接受肠切除术的早产儿在没有明确病因的情况下有复发腹膜炎的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Segmental absence of intestinal musculature increasingly recognized in premature infants with perforated viscus: A case series

Introduction

Segmental absence of intestinal musculature (SAIM) is a pathological diagnosis, denoting focal absence of the muscularis propria in the presence of intact surrounding structures. This condition often presents as spontaneous intestinal perforation (SIP) and can be difficult to distinguish clinically from necrotizing enterocolitis (NEC).

Case presentations

We present 5 cases of premature babies with gestational age ranging from 24 + 3 weeks up to 32 + 1 weeks, who all presented with intestinal perforation before the 15th day of life. Three patients presented with a distended abdomen and discoloration and were subsequently found to have pneumoperitoneum on abdominal x-ray (AXR). The 2 other patients presented with clinical deterioration but without signs of intestinal perforation and were subsequently found to have pneumoperitoneum on AXR. All underwent bowel resection of perforated bowel with either ileostomy with mucous fistula or primary end-to-end anastomosis. Two patients required repeat exploratory laparotomies within a week of their initial surgery due to pneumoperitoneum in subsequent AXR caused by new perforations in other parts of the small bowel. One patient sustained an iatrogenic liver injury intra-operatively and passed away 1 day post-operatively. All patients were found to have SAIM on histopathological examination.

Conclusion

SAIM is a pathological diagnosis that can manifest as SIP and may denote a risk for recurrent peritonitis in premature infants who underwent bowel resection for perforated viscus without a clear etiology.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
0.60
自引率
25.00%
发文量
348
审稿时长
15 days
期刊最新文献
Spontaneous enterocutaneous fistula in a neonate: A case report Inflammatory myofibroblastic tumor of the sigmoid colon: A case report 3D-printed model for surgical planning in congenital porto-systemic shunt: A case report Rapidly progressing necrotizing fasciitis with chickenpox infection: A case series Spigelian hernia diagnosed in a newborn: A case report
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1