Neonatal Intestinal Obstruction

Vinocur, Daniel; Lee, Edward Y.; Eisenberg, Ronald L.

doi:10.2214/ajr.11.6931

Cited by 58 publications

(87 citation statements)

References 11 publications

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“…These findings are almost consistent with the other studies. 2,12,14 As a rule, bilious vomiting in a newborn should be considered due to intestinal obstruction unless proved otherwise. [14][15][16] Wound infection was the commonest post-operative complication noted in our study.…”

Section: Discussionmentioning

confidence: 99%

Clinical study and management of intestinal obstruction in infants

Deshmukh

Maske

2016

Int Surg J

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Section: Discussionmentioning

confidence: 99%

Clinical study and management of intestinal obstruction in infants

Deshmukh

Maske

2016

Int Surg J

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“…28 In jejunal atresia, abdominal radiographs may demonstrate the "triple bubble sign" of three dilated air-filled structures representing the distended stomach, duodenum, and proximal jejunum. 28 Prior to surgery, an UGI contrast study is sometimes done as well as a contrast enema to evaluate for other atresias which may be concomitant. 28 The contrast enema will show a small and unused microcolon.…”

Section: 25mentioning

confidence: 99%

“…28 Prior to surgery, an UGI contrast study is sometimes done as well as a contrast enema to evaluate for other atresias which may be concomitant. 28 The contrast enema will show a small and unused microcolon. Ileal atresia may present with vomiting and failure to pass meconium.…”

Section: 25mentioning

confidence: 99%

“…28 UGI contrast study may also demonstrate intestinal malrotation with midgut volvulus, which manifests as duodenal obstruction or delayed passage of contrast through a corkscrew-shaped duodenum. 1 The sensitivity of UGI contrast study for detecting intestinal malrotation is 93%-100%, with both false positive and false negatives reported, while the sensitivity for detecting midgut volvulus is only 54-79%.…”

mentioning

confidence: 99%

“…29 Bowel obstruction and associated mesenteric vascular compromise may occur, leading to bowel ischemia and, eventually, infarction if untreated. 28 Short-gut syndrome, dependence on total parenteral nutrition, or even death may result due to bowel loss, with a mortality rate of 3%. 20 Treatment for intestinal malrotation with midgut volvulus includes fluid resuscitation, intravenous broad-spectrum antibiotics, and immediate surgical exploration.…”

mentioning

confidence: 99%

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Managing neonatal bowel obstruction: clinical perspectives

Desoky¹,

Kylat²,

Udayasankar³

et al. 2018

RRN

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Neonatal intestinal obstruction is a common surgical emergency and occurs in approximately 1 in 2,000 live births. The causes of obstruction are diverse with varied embryological origins, and some underlying etiologies are not yet well described. Some findings of neonatal bowel obstruction can be detected prenatally on ultrasound imaging. The obstruction is classified as "high" when the level of obstruction is proximal to the ileum, and "low" when the level of obstruction is at the ileum or colon. Early diagnosis of the type of intestinal obstruction and localization of the obstructive bowel segment guides timely and appropriate management of the underlying pathologic entity. Neonatal bowel obstructions are ideally managed at specialized centers with a large volume of neonatal surgery and dedicated pediatric surgical and anesthesia expertise. Although surgical intervention is necessary in most cases, initial management strategies often target underlying metabolic, cardiac, or respiratory abnormalities. Imaging plays a key role in early and accurate diagnosis of the abnormalities. When bowel obstruction is suspected clinically, initial imaging workup usually involves abdominal radiography, which may direct further evaluation with fluoroscopic examination such as upper gastrointestinal (UGI) contrast study or contrast enema. This article provides a comprehensive review of clinical and radiological features of common and less common causes of intestinal obstruction in the neonatal age group, including esophageal atresia, enteric duplication cysts, gastric volvulus, congenital microgastria, hypertrophic pyloric stenosis, duodenal atresia, intestinal malrotation, intussusception, intestinal atresia, meconium ileus, functional immaturity of the colon, Hirschsprung disease, and anorectal malformation. The embryology, epidemiology, clinical presentation, and brief medical and surgical management of each is described.

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