Managing neonatal bowel obstruction: clinical perspectives
[Full text] Managing neonatal bowel obstruction: clinical perspectives | RRN
Bowel obstruction is a common surgical emergency for newborns. Early diagnosis and appropriate treatment usually results in positive outcomes. Delay in carrying out surgery may result in the loss of large amounts of bowel. Infants diagnosed early and without fluid or electrolyte problems may be safely transferred with local ambulance services. Duodenal atresia may take the form of either a membranous or interrupted-type lesion at the level of the papilla of Vater. In 80 per cent of cases the papilla of Vater opens into the proximal duodenum causing the vomiting to be bilious.
Sigmoid volvulus in a neonate with imperforate anus.
Anorectal malformations ARMs commonly co-occur with other congenital anomalies, particularly VACTERL vertebral, anorectal, cardiac, tracheal, esophageal, renal, limb, and duodenal associations. However, this collection of associations is not comprehensive, and other concurrent anomalies may exist that can be missed during the standard work-up of patients with ARMs. We present a rare case of a neonate with a low ARM with concurrent jejuno-ileal atresia that was diagnosed after the correction of the ARM when the patient developed segmental volvulus. This case illustrates the importance of having a high index of suspicion when deviation from a classic presentation occurs. The incidence of anorectal malformations is approximately 1 in live births.
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