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收稿日期:2019年01月04日
录用日期:2019年1月14日
发布日期:2019年1月18日
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©2018 Serin ES。这是一篇开放获取的文章,根据创作共用署名许可的条款发布,允许在任何媒介上不受限制地使用、分发和复制,前提是要注明原作者和来源。
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Serin ES(2019)早产婴儿的便秘可能指出结肠狭窄。Glob Surg 5: DOI: 10.15761/GOS.1000202
土耳其阿达纳巴斯肯特大学医学院儿科外科
电子邮件:aa
DOI: 10.15761 / GOS.1000202
便秘,结肠狭窄,早产
亲爱的编辑,
肠狭窄是早产儿坏死性小肠结肠炎(NEC)的晚期并发症之一。肠梗阻可表现为胆汁性呕吐、腹胀或便秘等症状。在这里,我想强调一例因结肠狭窄导致便秘并伴有早产的病例。一名3个月大女性,因便秘腹胀6天入院。她有30孕周早产的故事,体重1930克。据她的母亲说,她在新生儿重症监护室随访了43天,由于大便带血,口服喂养已停止约10天。体检时体重3000克,腹部肿胀但柔软。直立腹部x线片显示气胀和无气骨盆(图1A)。患者有便秘、腹胀、躁动等远端肠梗阻症状。估计患儿出生后在NICU有NEC的临床图。 Contrast enema revealed 2 stricture sites in colon; middle of transvers colon (10 cm long) and between descending and sigmoid colon (15 cm long) (Figure 1B). She was operated, and two stricture regions of colon were resected, and 2 colo-colonic anastomoses were done (Figure 1C). Post- operative course was uneventful. She was discharged 7 days later. She was well with 11250 gr weigh in the first year of surgery. Necrotizing enterocolitis (NEC) is a severe gastrointestinal intestinal inflammatory process often effecting premature babies. It progresses with significant mortality rates in acute stage. Clinical presentations of NEC are feeding intolerance, abdominal distention, bloody stools and severe hemodynamic instability. Treatment consists of nasogastric suction, intravenous fluids, parenteral antibiotics and, in some cases surgery if intestinal obstruction or perforations are occurred [1,2]. But beyond acute stage, NEC has unignorable morbid complications such as short bowel syndrome and intestinal stricture which results of recovery of affected sites of ischemic intestinal segments [1,3]. It should be taken into consideration that in infants, who have obstructive symptoms with a history of premature birth, had developed post-NEC stricture [4]. It is reported that colon is the commonest site for stricture after NEC [5].When patients have intestinal obstruction with premature birth story, contrast enema is recommended to evaluate of colonic patency and to rule out diagnosis of stricture before operations [1,4,5]. It is known that if the stricture involved colonic segments patients can be asymptomatic for a while and tolerate feeding well until obstructive symptoms is occurred day by day. If prolonged constipation is not investigated patients can gradually face to high morbid complication such as intestinal obstruction, septicemia or perforation because of post-NEC strictures [1,5]. Colonic stricture following NEC should be index of suspicious for all clinicians who see the patients with premature birth story and with intestinal obstruction. Because the large intestine is storage organ the obstructive symptoms due to colonic stricture may not occur as early as obstructive symptoms of small intestinal stricture. I want to emphasize that colonic strictures should be stated in mind when premature birth infants present with constipation. For these reasons I wanted to explain how necessity of regular follow-up and information of family for such complications of NEC mentioned here, is important.
图1。一个。直立腹部x线片显示肠梗阻B。对比灌肠显示横结肠和降结肠狭窄C。手术中结肠狭窄
致编辑的信
收稿日期:2019年01月04日
录用日期:2019年1月14日
发布日期:2019年1月18日
©2018 Serin ES。这是一篇开放获取的文章,根据创作共用署名许可的条款发布,允许在任何媒介上不受限制地使用、分发和复制,前提是要注明原作者和来源。
Serin ES(2019)早产婴儿的便秘可能指出结肠狭窄。Glob Surg 5: DOI: 10.15761/GOS.1000202
巴斯肯特大学医学院儿科外科,阿达纳,土耳其,电话:90 (533)2583929
图1。一个。直立腹部x线片显示肠梗阻B。对比灌肠显示横结肠和降结肠狭窄C。手术中结肠狭窄