Gastroschisis with multiple atresia and impending rupture of small intestine
We herein report an unusual case of multiple atresia and impending rupture of the small intestine in a patient with gastroschisis. Gradual bowel dilatation and thinning of the bowel wall were confirmed at our institution by fetal imaging, which led to the suspicion of intestinal atresia. The patient...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-05-01
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| Series: | Journal of Pediatric Surgery Case Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213576619300387 |
| _version_ | 1811277680831627264 |
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| author | Tsubasa Shironomae Yutaka Hirayama Yasushi Iinuma Kyoko Morikawa Hirotomo Nakahara Koko Yoshida Takumi Kurabayashi |
| author_facet | Tsubasa Shironomae Yutaka Hirayama Yasushi Iinuma Kyoko Morikawa Hirotomo Nakahara Koko Yoshida Takumi Kurabayashi |
| author_sort | Tsubasa Shironomae |
| collection | DOAJ |
| description | We herein report an unusual case of multiple atresia and impending rupture of the small intestine in a patient with gastroschisis. Gradual bowel dilatation and thinning of the bowel wall were confirmed at our institution by fetal imaging, which led to the suspicion of intestinal atresia. The patient underwent repair of the perforation and small intestinal resection, formation of a separate stoma, and primary closure of the abdominal wall defect. The specimen from the impending rupture of the small intestine showed partial absence of the mucosal and muscular layers on the antimesenteric side and irregular thickness of the lamina and tunica muscularis, including the non-dilated intestine. The vascular density was lower in the area with absence of the mucosal and muscular layers than in the area with normal layers. We speculate that the multiple small intestinal lesions resulted from chronic vascular stress and high intestinal internal pressure. Intestinal lesions in patients with gastroschisis cannot be excluded even when dramatic bowel distention and thickening are absent on prenatal ultrasonography. In cases of prenatally diagnosed gastroschisis, cesarean delivery should be performed as soon as possible to minimize the damage caused by intestinal lesions. Keywords: Gastroschisis, Intestinal atresia, Intestinal impending rupture |
| first_indexed | 2024-04-13T00:21:07Z |
| format | Article |
| id | doaj.art-583083b1794e4a8f9ebf58c635e50aca |
| institution | Directory Open Access Journal |
| issn | 2213-5766 |
| language | English |
| last_indexed | 2024-04-13T00:21:07Z |
| publishDate | 2019-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Case Reports |
| spelling | doaj.art-583083b1794e4a8f9ebf58c635e50aca2022-12-22T03:10:46ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662019-05-0144Gastroschisis with multiple atresia and impending rupture of small intestineTsubasa Shironomae0Yutaka Hirayama1Yasushi Iinuma2Kyoko Morikawa3Hirotomo Nakahara4Koko Yoshida5Takumi Kurabayashi6Departments of Pediatric Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, Niigata 950-1197, Japan; Corresponding author. Department of Urology, Miyagi Children's Hospital, 4-3-17 Ochiai, Aoba-ku, Sendai, Miyagi 989-3126, Japan. Tel.: +81 22 391 5111; fax: +81 22 391 5116.Departments of Pediatric Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, Niigata 950-1197, JapanDepartments of Pediatric Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, Niigata 950-1197, JapanDepartment of Obstetrics and Gynecology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, Niigata 950-1197, JapanDepartments of Pediatric Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, Niigata 950-1197, JapanDepartment of Diagnostic Pathology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, Niigata 950-1197, JapanDepartment of Obstetrics and Gynecology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, Niigata 950-1197, JapanWe herein report an unusual case of multiple atresia and impending rupture of the small intestine in a patient with gastroschisis. Gradual bowel dilatation and thinning of the bowel wall were confirmed at our institution by fetal imaging, which led to the suspicion of intestinal atresia. The patient underwent repair of the perforation and small intestinal resection, formation of a separate stoma, and primary closure of the abdominal wall defect. The specimen from the impending rupture of the small intestine showed partial absence of the mucosal and muscular layers on the antimesenteric side and irregular thickness of the lamina and tunica muscularis, including the non-dilated intestine. The vascular density was lower in the area with absence of the mucosal and muscular layers than in the area with normal layers. We speculate that the multiple small intestinal lesions resulted from chronic vascular stress and high intestinal internal pressure. Intestinal lesions in patients with gastroschisis cannot be excluded even when dramatic bowel distention and thickening are absent on prenatal ultrasonography. In cases of prenatally diagnosed gastroschisis, cesarean delivery should be performed as soon as possible to minimize the damage caused by intestinal lesions. Keywords: Gastroschisis, Intestinal atresia, Intestinal impending rupturehttp://www.sciencedirect.com/science/article/pii/S2213576619300387 |
| spellingShingle | Tsubasa Shironomae Yutaka Hirayama Yasushi Iinuma Kyoko Morikawa Hirotomo Nakahara Koko Yoshida Takumi Kurabayashi Gastroschisis with multiple atresia and impending rupture of small intestine Journal of Pediatric Surgery Case Reports |
| title | Gastroschisis with multiple atresia and impending rupture of small intestine |
| title_full | Gastroschisis with multiple atresia and impending rupture of small intestine |
| title_fullStr | Gastroschisis with multiple atresia and impending rupture of small intestine |
| title_full_unstemmed | Gastroschisis with multiple atresia and impending rupture of small intestine |
| title_short | Gastroschisis with multiple atresia and impending rupture of small intestine |
| title_sort | gastroschisis with multiple atresia and impending rupture of small intestine |
| url | http://www.sciencedirect.com/science/article/pii/S2213576619300387 |
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