RESUMEN
Resection of a large vascular sacrococcygeal teratoma (SCT) in a newborn has the potential to be a fatal procedure caused by hemolysis, rupture, or bleeding of the tumor. Usually, most blood supply of an SCT is derived from the middle sacral artery. As soon as these arteries have been ligated, further blood loss is minimal. There is only one previous presentation about preoperative embolization of these arteries. We present a case in which the feeding arteries of a giant SCT were embolized in an infant born at 30 weeks and 3 days of gestation. Although bleeding during the surgery was minimal, continuous need of transfusions and life-threatening hyperkalemia created severe problems during surgery, until tumor resection was completed. This is the smallest reported patient in whom SCT was preoperatively treated by embolization.
Asunto(s)
Embolización Terapéutica/métodos , Cuidados Preoperatorios/métodos , Neoplasias de los Tejidos Blandos/cirugía , Neoplasias de los Tejidos Blandos/terapia , Teratoma/cirugía , Teratoma/terapia , Pérdida de Sangre Quirúrgica/prevención & control , Ablación por Catéter , Femenino , Enfermedades Fetales/diagnóstico por imagen , Hemorragia/prevención & control , Humanos , Hiperpotasemia/epidemiología , Recién Nacido , Recien Nacido Prematuro , Complicaciones Intraoperatorias/epidemiología , Región Sacrococcígea/irrigación sanguínea , Región Sacrococcígea/cirugía , Neoplasias de los Tejidos Blandos/irrigación sanguínea , Teratoma/irrigación sanguínea , Ultrasonografía PrenatalRESUMEN
We report an unusual case of nasogastric tube, during insertion, perforating the upper and lower segments of atretic esophagus (type C) and ending up in the stomach. Symptoms and imaging of the newborn are presented and the causative factors of the incident discussed.