Uncommon surgical emergencies in neonatology

Abstract

Objective. Over the past decade, multiple factors have changed the pattern of neonatal surgical emergencies. An increase in prenatal screenings and the development of neonatal tertiary care centres have changed the clinical approach to these kids. Materials and methods. Between 1995 to 2011 were retrospectively reviewed 34 patients with diagnosis of uncommon rare neonatal surgical emergencies at our institute. We analyzed: sex, gestational age, weight at birth, primary pathology, prenatal diagnosis, associated anomalies, age and weight at surgery, clinical presentation, start of oral feeding and hospitalization. The follow-up was performed at 6,12, 24 and 36 months. Results. There were 21 male and 13 female. The gestational age ranged between 28 and 36 weeks. The weight at birth ranged between 700 and 1400 grams. Oral feeding was started between 4th and 10th postoperative day. The average hospitalization was about 70.47 days. To date, all patients have finished the followup. They are healthy. Conclusion. The outcome of the patients with uncommon surgical emergencies is different based on the etiology. Overall survival is generally good but is influenced by the associated anomalies.

Persistent Nonbilious Vomiting in a Child: Possible Duodenal Webbing

“…The most common presentation of malrotation is bilious vomiting due to duodenal obstruction from intermittent midgut volvulus rather than compression by Ladd’s bands or kinking of the duodenum [4]. However, in some patients, malrotation is discovered incidentally during radiographic studies or during laparotomy performed for other indications [1,2,5,6]. …”

“…A symptomatic association between a malrotation and a congenital duodenal web is rare and few cases have been reported in the literature. The true incidence of malrotation is not fully known; however, it is reported as approximately 1 in 500 live births [1,2]. The incidence of duodenal web as a cause of intestinal obstruction is reported to be between 1:10,000 to 1:40,000 [3,4].…”

Recycling of Stoma Losses: A Good Practice for Neonates with High Output Stomas—Our Experience and Comparison with Literature

“…More than one half of these conditions are typical of neonatal period, such bowel perforation, volvulus, atresia, necrotizing enterocolitis, and meconium disease. 9 Furthermore, the improvement of medical management of extremely low birth weight and premature neonates have been resulted both in an increased survival of these babies and in a raise of surgical conditions prematurity linked that may need stomas. 10 This kind of surgical technique raised a role of critical importance in the management of neonates affected by abdominal surgical diseases.…”