medigraphic.com

2006, Number 1

<< Back

Rev Mex Cir Pediatr 2006; 13 (1)

Prenatal Diagnosis: Jejunal Atresia Special Solution: A Team Miltidisciplinario

Milan-Montenegro JG, Salazar-Chavira JL, Hernández-Flores JG, Arizpe-Gutierrez A, Gonzalez-Ortega S

Language: Spanish
References: 20
Page: 39-43
PDF size: 375.52 Kb.


ABSTRACT

Introduction: Proceeding with prenatal diagnosis of congenital malformations, is a reality, even more, when the kid’s mother presents polhidramnios in prenatal control and where an ecosonogram permitted us to diagnose the Yeyuno Atresia, always counting on help from a first class private hospital, where we performed complete treatment to obtain a good quality of life for the child.
Clinical Case: Premature membrane rupture of 37 year old first child mother, led us to cesarea; immediately confirmed by clinical and X rays diagnosis. Proceeded with surgery 16 minutes after born, identifying Yeyuno Atresia type III b with separated ends, “Apple peel” mesentery and intestinal malrotation. Post surgery evolution: 8 days without food, TPN*, got rid of oral tubes, fed orally up to maternal milk.
Conclusions: Pregnant pacient with polhidramnios requires abdominal ecosonogram to diagnose digestive tube malformation, which has to be confirmed at N/B leading to immediate surgery with special medical equipment as well as a specialized surgery team. We recommend the applied technique, with a complete involvement from a Neonatologist in NICU**, total parenteral nutrition in first class hospital that will contribute in obtaining excellent results.


REFERENCES

  1. Louw,J.H.,Barnard C.N,, Congenital intestinal atresia. Observations in its origin. Lancet. 1955;2:1065.

  2. Tandler,J.; Embrorcklungsgensnuchte des menslilichen duodenum in fuhern embryonalstadien. Gegenbours morfol jahrb; q900: 29:187., tomado de Hpñder tT:M:, Aschcraft K.W:; Cirugía Pediátrica. Edit. Interamericana, 1984; 367.

  3. EvansC:_H:, Collective review: Atresias of the gastrointestinal tract. Surg. Gynecolog. Obstet., 1951; 92:1.

  4. Toulukian j, Tomado de cirugía pediatrica Holdert,t,m,Ashcraft K,W, Edit.- interamericana, 1984;367-83.

  5. Santulli T.V., Chin C.C., and Schullinger J:_N:, : Management of congenital atresia os the intestine. Amer. Jour. Surg., 1970; 119:542.

  6. Toulukian R:J:: Intestinal atresia. Clinical Perinatol.: 1978; 5:3.

  7. Jiménez M.J., Garciá J:A:,Melgoza H:M:; Trabajo presentadoen XXVIII Congreso Nacional de Cirugía Pediatrica. Cd. Juárez Chih., 12-15 Sept. 2004.

  8. Filippo D, Gomez t, Rodríguez S, Martinez F, M, Felipe L, Mogull S,Radiologia en obstrucción intestinal del recien nacido.Rev. Arg. Radiol.1999:63

  9. Swenney B, Surana R, Puri P, Jejunoileal atresia and associated malformations: correlation with the timing of in utero insut. J, Pediat, Surg, 2001;36: 774-76.

  10. Sato S, Nishima E, Tsugawa c, Kimura K, Jejuno-ileal atresia:_ a 27 year experience. J. Pediat, Surg, 1998; 33:1633-35.

  11. Sociedad Mexicana Cirugía Pediatrica. Manual de Cirugía Pediátrica; 1997; 36-37.

  12. Heij H,A, Moorman-Voestermans C,G,M, Vos A, 1990; 25:_635-37-.

  13. Tam P,K, Nicholls G, Implications of antenatal diagnosis of small intestine atresia in the 1990s. Pediatr, Surg, Int, 1999; 15:486-87.

  14. Amole A;O;Johnson A,W, Adessiyun O;A;The diagnostic value of the triple bubble sign in proximal yeyunal atresia:a case report. Afr,J,Med,Sci.,2003; 32:95-98

  15. Takahashi A, Susuki N, Ikeda H, Kurowa M, Tomomasa T, Tsuchda Y, y cols. Results of bowel plication in addition to primary anastomosis in patients with jejunal atresia. J, Pediat, Surg, 2001:36: 1752-56.

  16. Kimura K, Perdzinski W, Soper R, Elliptical seromuscular resection for tapering the proximal dilated bowel in duodenal o jejunal atresia. J. Pediat, Surg, 1996; 31: 1405.-06.

  17. Turnock R, Bereton R,J, Spitz L, Kiely E,M, Primary anastomosis in apple peel bowel syndrome J. Pediatr, Surg, 1991; 26: 718-20

  18. PAC.Neonatología libro 2. Nutricion parenteral en el recien nacido. 2002;107-

  19. Queroi J:J:, Enterocolitis necrotizante como forma de debut de atresia yeyuno-ileal de evolucion fatal. Rev. Esp. Ped. 1998;54:264-67.

  20. Waldhaussen J,H, Sawin R,S, Improved log-term outcome for patients with jejunoileal apple peel atresia. J. Pediatr, Surg, 1997; 32: 1307-09




2020     |     www.medigraphic.com