Loop Ileostomy in Europe's Tiniest Male Newborn for Meconium-Related Ileus
With the advances of neonatology, the survival rate for “live-born periviable fetuses” weighing < 300 g, a subgroup of extremely low birth weight (BW) infants, has improved over the past 10 years. Meconium-related ileus (MRI) represents an early postnatal hazard, and, if medical evacuation fails,...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Georg Thieme Verlag KG
2021-01-01
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| Series: | European Journal of Pediatric Surgery Reports |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1721406 |
| _version_ | 1818574466527002624 |
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| author | Holger Till Georg Singer Christoph Castellani Berndt Urlesberger |
| author_facet | Holger Till Georg Singer Christoph Castellani Berndt Urlesberger |
| author_sort | Holger Till |
| collection | DOAJ |
| description | With the advances of neonatology, the survival rate for “live-born periviable fetuses” weighing < 300 g, a subgroup of extremely low birth weight (BW) infants, has improved over the past 10 years. Meconium-related ileus (MRI) represents an early postnatal hazard, and, if medical evacuation fails, a surgical challenge in such immature babies. We report the interdisciplinary management of surgically treated MRI in a newborn with a BW of 273 g. According to the worldwide database held by the University of Iowa, he is registered as the tiniest male newborn in Europe. The boy was born in the 25th gestational week by cesarean section after a triplet pregnancy with twin–twin transfusion syndrome, him being the donor. He had a BW of 273 g, whereas his brothers had a BW of 740 g and 722 g. Cardiopulmonary stabilization and ventilation were successful. He developed MRI unresponsive to medical treatment. On day 14 of life, a minilaparotomy was performed in the right lower quadrant to externalize a loop of the distal ileum in a no-touch technique. Despite the small diameter of only 2 mm, a standard loop ileostomy could be fashioned. There were no intra- or postoperative abdominal complications. Bowel function and weight gain were adequate and the ileostomy was closed electively 5 months later at a body weight of 3.5 kg. In summary, minilaparotomy and loop ileostomy placement were effective to treat surgical MRI in Europe's tiniest male newborn. With the advances of neonatology, pediatric surgery reaches new frontiers as well. |
| first_indexed | 2024-12-15T00:27:02Z |
| format | Article |
| id | doaj.art-a38bcba699344fb284d93f01cdcc8af1 |
| institution | Directory Open Access Journal |
| issn | 2194-7619 2194-7627 |
| language | English |
| last_indexed | 2024-12-15T00:27:02Z |
| publishDate | 2021-01-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | European Journal of Pediatric Surgery Reports |
| spelling | doaj.art-a38bcba699344fb284d93f01cdcc8af12022-12-21T22:42:08ZengGeorg Thieme Verlag KGEuropean Journal of Pediatric Surgery Reports2194-76192194-76272021-01-010901e17e1910.1055/s-0040-1721406Loop Ileostomy in Europe's Tiniest Male Newborn for Meconium-Related IleusHolger Till0Georg Singer1Christoph Castellani2Berndt Urlesberger3Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, AustriaDepartment of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, AustriaDepartment of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, AustriaDepartment of Paediatrics and Adolescent Medicine, Division of Neonatology, Medical University of Graz, Graz, AustriaWith the advances of neonatology, the survival rate for “live-born periviable fetuses” weighing < 300 g, a subgroup of extremely low birth weight (BW) infants, has improved over the past 10 years. Meconium-related ileus (MRI) represents an early postnatal hazard, and, if medical evacuation fails, a surgical challenge in such immature babies. We report the interdisciplinary management of surgically treated MRI in a newborn with a BW of 273 g. According to the worldwide database held by the University of Iowa, he is registered as the tiniest male newborn in Europe. The boy was born in the 25th gestational week by cesarean section after a triplet pregnancy with twin–twin transfusion syndrome, him being the donor. He had a BW of 273 g, whereas his brothers had a BW of 740 g and 722 g. Cardiopulmonary stabilization and ventilation were successful. He developed MRI unresponsive to medical treatment. On day 14 of life, a minilaparotomy was performed in the right lower quadrant to externalize a loop of the distal ileum in a no-touch technique. Despite the small diameter of only 2 mm, a standard loop ileostomy could be fashioned. There were no intra- or postoperative abdominal complications. Bowel function and weight gain were adequate and the ileostomy was closed electively 5 months later at a body weight of 3.5 kg. In summary, minilaparotomy and loop ileostomy placement were effective to treat surgical MRI in Europe's tiniest male newborn. With the advances of neonatology, pediatric surgery reaches new frontiers as well.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1721406laparotomyloop ileostomyperiviable fetusmeconium-related ileusextremely low birth weight |
| spellingShingle | Holger Till Georg Singer Christoph Castellani Berndt Urlesberger Loop Ileostomy in Europe's Tiniest Male Newborn for Meconium-Related Ileus European Journal of Pediatric Surgery Reports laparotomy loop ileostomy periviable fetus meconium-related ileus extremely low birth weight |
| title | Loop Ileostomy in Europe's Tiniest Male Newborn for Meconium-Related Ileus |
| title_full | Loop Ileostomy in Europe's Tiniest Male Newborn for Meconium-Related Ileus |
| title_fullStr | Loop Ileostomy in Europe's Tiniest Male Newborn for Meconium-Related Ileus |
| title_full_unstemmed | Loop Ileostomy in Europe's Tiniest Male Newborn for Meconium-Related Ileus |
| title_short | Loop Ileostomy in Europe's Tiniest Male Newborn for Meconium-Related Ileus |
| title_sort | loop ileostomy in europe s tiniest male newborn for meconium related ileus |
| topic | laparotomy loop ileostomy periviable fetus meconium-related ileus extremely low birth weight |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1721406 |
| work_keys_str_mv | AT holgertill loopileostomyineuropestiniestmalenewbornformeconiumrelatedileus AT georgsinger loopileostomyineuropestiniestmalenewbornformeconiumrelatedileus AT christophcastellani loopileostomyineuropestiniestmalenewbornformeconiumrelatedileus AT berndturlesberger loopileostomyineuropestiniestmalenewbornformeconiumrelatedileus |