RESUMEN
Meconium obstruction of prematurity is an entity primarily affecting very low birthweight or extremely low birthweight babies causing low intestinal obstruction. Its presence may at best delay establishment of enteral feeding and compromise nutrition and at worst lead to mechanical obstruction requiring surgery or to intestinal perforation. There are considerable challenges in the recognition, diagnosis and management of this condition. Awareness of the disease and understanding of its pathogenesis may lead to early detection of affected babies and allow proactive measures to decrease the associated morbidity and mortality.
Asunto(s)
Enfermedades del Prematuro/terapia , Obstrucción Intestinal/terapia , Meconio , Diagnóstico Precoz , Humanos , Recién Nacido , Recien Nacido Prematuro , Enfermedades del Prematuro/diagnóstico , Enfermedades del Prematuro/fisiopatología , Recién Nacido de muy Bajo Peso , Obstrucción Intestinal/diagnóstico , Obstrucción Intestinal/fisiopatologíaRESUMEN
We report two cases of spontaneous colonic perforation associated with cystic fibrosis (CF) in the neonatal period. Both presented with an acute abdomen soon after birth and required laparotomy and stoma formation. Colonic perforation as an initial presentation of CF is reviewed and management options are discussed.
Asunto(s)
Enfermedades del Colon/etiología , Fibrosis Quística/complicaciones , Perforación Intestinal/etiología , Biopsia , Enfermedades del Colon/diagnóstico , Enfermedades del Colon/cirugía , Fibrosis Quística/diagnóstico , Diagnóstico Diferencial , Estudios de Seguimiento , Humanos , Ileostomía/métodos , Recién Nacido , Perforación Intestinal/diagnóstico , Perforación Intestinal/cirugía , Laparotomía/métodos , Masculino , Radiografía Abdominal , Rotura EspontáneaRESUMEN
AIM: Few retrospective studies have evaluated infants with hypertrophic pyloric stenosis (HPS) for associated urological anomalies. They have led to contradictory conclusions. The aim of this study was to evaluate the incidence of urinary tract anomalies in infants with HPS and to establish the clinical significance of this association. METHODS: One hundred and twenty-two infants (100 boys) who underwent pyloromyotomy between 1992 and 2002 were prospectively evaluated. Screening ultrasound (Us) of the urinary tract was performed in 107 infants, while 15 did not attend their ultrasound appointment. RESULTS: Renal ultrasound was abnormal in 4 (4%) of 107 screened patients with HPS. Three patients were found to have mild hydronephrosis and, in one patient, a small, normal kidney was detected. Two patients with hydronephrosis had Us follow-up and the third patient underwent Tc-99 mercaptoacetyl triglycine (MAG 3) scan. In all three patients, the hydronephrosis resolved completely on follow-up scan. CONCLUSION: The incidence of abnormal renal ultrasound in children with HPS is similar to the reported incidence of 3-6% determined with routine ultrasound screening of healthy newborns. The abnormalities detected were not clinically relevant and did not require surgical intervention. We do not recommend screening of the urinary tract in infants with HPS.