Cruz-Flores P, Barajas RJairo-Israel, Rodríguez-Mejía EJ, Rodríguezde LG, Andrade-Baeza RE

Language: Spanish
References: 7
Page: 256-259
PDF size: 500.71 Kb.

ABSTRACT

Intestinal arteriovenous malformations (AVM) are high flow vascular anomalies arising from an embryogenesis error, due to direct communication ofvein and an artery, without capillary bed in between them. There are few reports of intestinal AVM in neonates. Most of them are isolated and genetic defects have not been found. Definitive diagnosis is established through histopathologic studies.
We present a newborn, offspring of a primigest mother, with adequate prenatal control, with pregnancy ultrasounds showing no evidence of malformations. Cesarean delivery was performed due to HELLP syndrome at 32 weeks ofgestation, APGAR at birth was 8/9, and Silverman Andersen score 0/2/3, weight at birth was 1300 grams and length of 37 cm. The newborn was admitted to NICU due to respiratory distress syndrome and prematurity (gestational age of 32 weeks), no apparent malformations were reported. Treatment and hospital management was done following clinical practice guidelines, according to his diagnoses at admission. During his tenth day of life, he developed sudden abdominal distension, along with clinical and radiographic data suggestive of intestinal perforation.
Immediately treatment was started with intravenous solutions, vasopressors, metabolic acidosis correction and penrose drain abdominal decompression. Sudden cardiac arrest occurred and in spite of cardiovascularsupport, the patient failed to respond. The autopsy reported an AVMwith a length of 4cm, located in mesocolon and outer external colon wall of the transverse colon with perforation. Acute generalized peritonitis was found without data suggesting necrotizing enterocolitis.
The presence of intestinal arteriovenous malformations in neonates is an infrequent diagnosis and cause of death. It is fundamental to continue the practice of autopsies in hospitals.

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