Meckel's Diverticulum In a Premature Infant

Abstract

superficial saphenous vein was identi¬ fied and isolated. Then under fluoro¬ scopic control, the pervenous electrode was passed up through the vena cava and guided through the right atrium and into the right ventricle. The pace¬ maker was then reattached. and sat¬ isfactory complexes could be seen on the oscilloscope. The pulse returned to the preset rate of 72 beats per minute.In using this new approach, we found to our chagrin that there was only 1 cm of electrode remaining out¬ side of the entrance to the vein. How¬ ever, by fashioning a pocket just above the inguinal ligament and subcutaneously, it was possible to implant the pacemaker there. The skin was freed sufficiently so that closure with¬ out tension could be effected.-Both electrode tip and pulse generator re¬ mained in their positions, and the pa¬ tient made an uneventful recovery from the manipulations. Approximate¬ ly 11 days later she was transferred to a nursing home where at last re¬ port she was alert, well, and quite happy.To our knowledge, this is the first report of using the femoral re¬ gion for implantation of a perma¬ nent pacemaker. Were it not for the difficulty in working the elec¬ trode tip to the right ventricle by this route, and the longer perve¬ nous electrode wire needed, this might be a suitable place for im¬ plantation of pacemakers in such patients. scription of the congenital diverticulum of the small intestine in 1809,' the medical literature discussing this anomaly has increased steadily. We report the case of a 36-hour-old premature infant with a giant Meckel's diverticulum visualized as a gas shadow on the roentgenogram of the abdomen. Report of A Case:\p=m-\This 1,830-gm premature male infant was born spontaneously (breech presentation) to a gravida 2, para 1, 33-year-old Negro mother on Dec 10, 1965, at Charity Hospital, New Orleans. The date of the mother's last menstrual period was unknown. Serologic tests for syphilis performed on blood obtained at delivery showed a positive VDRL slide test at one dilution and a weakly positive Kolmer's test. The amniotic sac leaked for approximately 24 hours prior to delivery. After birth, the Apgar score was 6 at one minute and 8 at five minutes. On admission to the Premature Center, this infant showed moderate respiratory distress. Decreased breath sounds and scattered rales were audi¬ ble in both lung fields. The abdomen was slightly distended. Heart sounds were regular with a rate of 140 beats per minute. The rectal temperature was 95.6 F. Both kidneys were palpa¬ ble. Bilateral microphthalmia, polydactylia and a right hammer toe were present. When the infant was 24 hours old. oral feedings were started. However, he became moderately cyanotic after each feeding. At 36 hours of age, the abdomen became distended and the infant vomited once. A soft movable mass, not well delineated, was felt to the left of the umbilical region. Bowel sounds were present, and the infant was able to pass flatus. Two meconium stools and then a transitional stool with bright red, nondigested blood were...