Background: Bilious vomiting is a common symptom of neonatal intestinal obstruction. The etiology is mostly related to congenital anomalies and other conditions causing intestinal obstruction.
Case Presentation: We report a case of a seven days male premature baby (35 Weeks) that presented with features of intestinal obstruction including bilious vomiting and abdominal distention. X-ray abdomen showed features of complete small bowel obstruction. On laparotomy, the baby had acute appendicitis causing multiple adhesions, and an adhesion band was responsible for intestinal obstruction. Adhesions were divided, and appendectomy performed. Postoperatively the baby had an uneventful recovery and was discharged in a stable condition.
Conclusion: Neonatal appendicitis causing intestinal obstruction is a rare phenomenon and should be considered in the differential diagnosis of babies presenting with bilious vomiting.
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Traumatic duodenal perforation is a serious injury and is a result of major trauma and insult to the body. The management is difficult due to
associated injuries and these children often need major resuscitation. The standard surgical treatment of traumatic duodenal perforation is
laparotomy and repair of duodenal perforation. In children, laparoscopic repair of duodenal perforation is reported in only a few cases. A repair of
a near-complete duodenal transaction is not reported in the pediatric population. Herein, we report a case of an eight years old child who had a road
traffic accident, and sustained multiple injuries and duodenal perforation, as confirmed by radiological evaluation including CT abdomen. The
child was resuscitated, and later laparoscopy was performed, which showed gross bruising of the abdominal wall and a near-complete transaction
at the level of 3rd part of the duodenum. Laparoscopic repair of the duodenum was performed using interrupted polyglycolic sutures. The child had
a smooth post-op recovery and was discharged home in stable condition. At one-year follow-up, the child remained well and symptom-free. This
case highlights the role of the safety of laparoscopic surgery in abdominal trauma and duodenal perforations.
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