Perforation of the colon in neonates

Komuro, Hiroaki; Urita, Yasuhisa; Hori, Tomohide; Hirai, Misako; Kudou, Sumi; Gotoh, Chikashi; Kawakami, Hajime; Kaneko, Michio

doi:10.1016/j.jpedsurg.2005.08.006

Cited by 30 publications

(28 citation statements)

References 19 publications

(35 reference statements)

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“…From these histological findings and the fact that FIP occurs exclusively in very-low-birth-weight neonates, we speculate that immature or uncoordinated bowel movement causes a localized increase in intraluminal pressure and leads to focal perforation or bulging at the sites of defects of muscular layer. The fact that in cases of total colonic or extensive aganglionosis, in which impaired bowel movement is characteristic, perforation developed in the aganglionic colon or proximal colon distant from the transitional zone [18,19] may support our speculation. Focal intestinal perforation has been reported to occur with lower or equal frequency compared with NEC [4][5][6].…”

Section: Histological Findings Around the Perforationsupporting

confidence: 60%

Focal intestinal perforation in extremely-low-birth-weight neonates: etiological consideration from histological findings

et al. 2007

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In Japan, mortality due to intestinal perforation has been increasing for the last 15 years, as the survival rate of extremely-low-birth-weight neonates (ELBWs) has been increasing. In our NICU, although the incidence of necrotizing enterocolitis has been decreasing, that of focal intestinal perforation (FIP) has been increasing. To elucidate the pathogenesis of FIP, a histological study was performed. For the last 20 years, in our NICU, 11 ELBWs with FIP, including one with multiple perforations and impending rupture, underwent laparotomy and enterostomy. The intestinal wall around the perforation was resected for histological study. Histological studies revealed well-developed ganglion cells in all the cases. Although some lymphocytic infiltration and hemorrhage were observed, no apparent neutrophilic infiltration, or necrotic change was identified in any case. No evidence of microcirculatory impairment was identified. The intestinal musculature discontinued abruptly with thinning in three cases, and without thinning in the others. The histology of impending rupture showed an absence of the muscularis with preservation of the remaining components of the bowel wall. The findings that the punched-out perforations had the appearance of Hirschsprung's disease, FIP exclusively occurred in ELBWs, and that neither mechanical obstruction nor necrotic change could be identified as the cause of the perforation suggest that immature bowel movement and congenital muscle defects may be involved in the pathogenesis of FIP.

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Section: Histological Findings Around the Perforationsupporting

confidence: 60%

Focal intestinal perforation in extremely-low-birth-weight neonates: etiological consideration from histological findings

et al. 2007

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“…Prolonged rupture of the membranes, maternal infections, fetal distress, lower APGAR score, recurrent apneic episodes, hypotension, presence of intraumbilical vascular catheter, exchange transfusion, and PDA are some of the conditions leading to low-flow states and hypoxia. In full-term infants, NEC is seen considerably at an earlier stage, which is thought to be related to prematurely initiated formula feeding (2,4,5,(7)(8)(9)(10)(11)(12)(13)(14). As well as in our patient, a history of birth asphyxia secondary to prolonged labor and enteral feeding was elicited.…”

Section: Discussionmentioning

confidence: 99%

“…Necrotizing enterocolitis (NEC), Hirschsprung disease (HD), anorectal malformations (ARMs), and mechanical obstructions, like intestinal atresias, small left colon syndrome, meconium plaque syndrome, stercoral perforation, idiopathic perforation, cystic fibrosis, and isolated intestinal perforation, are some of the causes of colonic perforation occurring during the neonatal period (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Neonatal colonic perforation

Saraç

Ataoğlu

Tatar

et al. 2015

UCD

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Neonatal colonic perforation is a rarely seen condition. Plain abdominal radiography of a 28-hour newborn consulted for vomiting and bloody stool revealed the presence of subdiaphragmatic free air, which necessitated surgical exploration. Transverse colonic perforation was detected during the exploration, and subsequently, a colostomy and appendectomy were performed. The postoperative follow-up period was uneventful. Necrotizing enterocolitis, Hirschsprung disease, and mechanical obstruction are some of the causes of colonic perforation during the neonatal period. Herein, we have shared a case of colonic perforation in an asphyctic newborn delivered after prolonged labor.

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“…Так, по данным некоторых авторов, у 2 из 8 детей причиной перфорации тон-кой кишки в периоде новорожденности была болезнь Гиршпрунга, что позволило рекомендовать проведе-ние диагностических мероприятий по исключению обструкции и проведению многоуровневой биопсии толстой кишки у всех новорожденных с перфораци-ями ЖКТ [1,10]. В других исследованиях причиной перфорации подвздошной кишки в 75% случаев был некротический энтероколит, и лишь у 1 из 175 паци-ентов выявлена болезнь Гиршпрунга [10]. В серии исследований показано, что причиной перфорации у 3 из 56 новорожденных был тотальный аганглиоз толстой кишки.…”

Section: клинический примерunclassified

“…[1]. Гиршпрунг-ассоциированный энтероко-лит встречается в 20-58% случаев и является самым частым и грозным осложнением заболевания [10].…”

Section: клинический примерunclassified

Malformations of Intestine in Premature Infants under the Mask of Necrotizing Enterocolitis

Кучеров¹,

Жиркова²,

Шишкина³

et al. 2015

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Perforation of the colon in neonates

Cited by 30 publications

References 19 publications

Focal intestinal perforation in extremely-low-birth-weight neonates: etiological consideration from histological findings

Focal intestinal perforation in extremely-low-birth-weight neonates: etiological consideration from histological findings

Neonatal colonic perforation

Malformations of Intestine in Premature Infants under the Mask of Necrotizing Enterocolitis

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