RESUMO
Brachial plexus birth injury (BPBI) and phrenic nerve injury can sometimes occur concurrently in neonates following difficult deliveries like breech presentation, shoulder dystocia, forceps or vacuum extraction. Phrenic nerve palsy should be suspected in a newborn with respiratory distress and an elevated hemidiaphragm on the imaging studies in presence of the associated risk factors. The right side is affected more often than the left side and most of it is associated with BPBI. We present here a rare case of a newborn baby with a left-sided Erb's palsy and a contralateral/right-sided diaphragmatic paralysis who recovered from the persistent respiratory distress and feeding difficulties following plication of the diaphragm. The left-sided Erb's palsy also fully recovered at follow-up examination.
Assuntos
Traumatismos do Nascimento/fisiopatologia , Neuropatias do Plexo Braquial/fisiopatologia , Diafragma/fisiopatologia , Diafragma/cirurgia , Paralisia/fisiopatologia , Vácuo-Extração/efeitos adversos , Traumatismos do Nascimento/cirurgia , Plexo Braquial/fisiopatologia , Neuropatias do Plexo Braquial/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Recém-Nascido , Paralisia/cirurgia , Fatores de RiscoRESUMO
The ease of access and advantages of a secure central line makes use of umbilical venous catheter (UVC) and umbilical artery catheters a part of the standard of care in the extremely premature babies in the neonatal intensive care unit. However, there are complications associated with their use. One of the uncommon complications reported is total parenteral nutrition (TPN) ascites secondary to vessel perforation or hepatic erosion by the tip of the catheter due to malposition of a UVC. We present here a case of such catheter perforation causing ascites and right hepatic collection of TPN in a 28-week-old infant. Abdominal paracentesis was therapeutic by relieving the distension as well as confirming the presence of parenteral nutrition in the peritoneal cavity.
