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>Journals >Acta Pediátrica de México >Year 2013, Issue 3


Mejía-Camacho D, Alvarado-García R , Jiménez-Urueta PS, Pacheco-Mendoza BA, García-Leguízamo K
Extensive intestinal necrosis associated with volvulus. Deferred treatment
Acta Pediatr Mex 2013; 34 (3)

Language: Español
References: 7
Page: 123-126
PDF: 206.89 Kb.


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ABSTRACT

Intestinal malrotation with volvulus and extensive necrosisis is the deadliest emergency faced by the pediatric surgeon. Treatment consists in surgical repair using the technique described by William Ladd in 1936. In some cases where viability is in questionable a second look laparotomy upon placement of drains has been described. We report the case of a one month old infant with cloacal extrophy who had an intestinal volvulus. During the surgical procedure necrosis of more than 90% of the vowel was seen. Surgical drains were placed and second look laparotomy six weeks later was performed with intestinal recovery of 70%.


Key words: Intestinal malrotation, volvulus, short bowel syndrome, second look laparotomy.


REFERENCIAS

  1. Shew SB. Surgical concerns in malrotation and midgut volvulus. Pediatr Radiol. 2009;39(Suppl 2):S167–S71.

  2. Baeza HC, Escobar IMA, Martínez RML, García CLM, Nájera GHM. Malrotación y vólvulo intestinal perinatal. Acta Pediatr Mex 2008;29(2):73-7.

  3. Okada T, Yoshida, Iwai J, Matsunaga T. Pulsed Doppler sonography for the diagnosis of strangulation in small bowel obstruction. J Pediatr Surg. 2001;36:430-5.

  4. Lampl B, Levin TL, Berdon WE, Cowles RA. Malrotation and midgut volvulus: a historical review and current controversies in diagnosis and management. Pediatr Radiol. 2009;39:359–66.

  5. Houben CH, Mitton S, Capps S. Malrotation volvulus in a neonate: a novel surgical approach. Pediatr Surg Int. 2006;22:393–4.

  6. Moore TC, Collins DL, Nguyen M. Marked (24-fold) elevation of peritoneal cavity drainage fluid vascular endothelial growth factor after successful ‘‘patch, drain, and wait’’ approach for extensive midgut necrosis in a newborn. Pediatr Surg Int. 2002;18:400–4.

  7. Moore TC. Successful use of the ‘‘patch, drain and wait’’ laparotomy approach to perforated necrotizing enterocolitis: is hypoxia-triggered ‘‘good angiogenesis’’ involved? Pediatr Surg Int. 2000;16:356–63.






>Journals >Acta Pediátrica de México >Year 2013, Issue 3
 

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