RESUMO
UNLABELLED: The aetiopathology of extrahepatic portal vein obstruction is unknown. In retrospective studies, umbilical vein cannulation and sepsis have been alleged to cause portal thrombosis. This prospective study was undertaken to detect whether thrombosis and consequent obstruction of the splenoportal venous system develops after umbilical vein catheterization for exchange transfusion in newborns using Doppler ultrasound. Forty children (M = 24; F = 16) who had undergone exchange transfusion for hyperbilirubinaemia were studied at school age. Maximal duration of the venous umbilical cannulation was 120 min and sepsis did not occur. Clinical, biological and sonographic examinations were normal, except in 3 children. In 2 the left branch of portal vein could not be identified (normal variant). CONCLUSION: Our results show that, in these children, umbilical vein catheterization did not lead to development of portal vein thrombosis. However, when other risk factors such as umbilical infection, traumatic catheterization are associated, children should be screened for obstruction of the portal vein.
Assuntos
Transfusão Total/efeitos adversos , Transfusão Total/métodos , Veia Porta , Trombose/etiologia , Veias Umbilicais , Criança , Feminino , Humanos , Hiperbilirrubinemia/terapia , Recém-Nascido , Masculino , Veia Porta/diagnóstico por imagem , Estudos Prospectivos , Ultrassonografia Doppler em CoresRESUMO
Atresia of the colon (AC) is an uncommon cause of neonatal intestinal obstruction requiring prompt surgery. However, its optimal operative management is matter of discussion. We report the surgical therapy and evolution of three cases successfully treated at our department. A type I case was submitted to a coloplasty plus resection of the diaphragm; two cases of type III underwent a two-staged procedure, i.e., colostomy with subsequent anastomosis without resection. After analysing the different operative procedures we suggest that a colostomy with later establishment of intestinal continuity may be an advantageous procedure even in the healthy patients with proximal lesions. A coloplasty is a safe alternative to type I atresias.
