Early intestinal perforation secondary to congenital mesenteric defects
Gastrointestinal perforation (GIP) in preterm neonates may be idiopathic, due to necrotizing enterocolitis (NEC), or mechanical obstruction. The predominant cause of GIP in the neonatal period is NEC. Differential diagnosis with congenital malformations, including mesenteric defects leading to inter...
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| Format: | Article |
| Language: | English |
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Elsevier
2016-05-01
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| Series: | Journal of Pediatric Surgery Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213576615300439 |
| _version_ | 1818524699695513600 |
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| author | Ingrid Anne Mandy Schierz Mario Giuffrè Mariaserena Lo Presti Giuseppa Pinello Cinzia Chiaramonte Enrica Maria Agosta Cecala Giovanni Corsello |
| author_facet | Ingrid Anne Mandy Schierz Mario Giuffrè Mariaserena Lo Presti Giuseppa Pinello Cinzia Chiaramonte Enrica Maria Agosta Cecala Giovanni Corsello |
| author_sort | Ingrid Anne Mandy Schierz |
| collection | DOAJ |
| description | Gastrointestinal perforation (GIP) in preterm neonates may be idiopathic, due to necrotizing enterocolitis (NEC), or mechanical obstruction. The predominant cause of GIP in the neonatal period is NEC. Differential diagnosis with congenital malformations, including mesenteric defects leading to internal hernias, is mandatory if the onset is early. We describe two newborns with trans-mesenteric herniation resulting in GIP, and we discuss the presence of possible additional risk factors such as prematurity and predisposing vascular disruption in connective tissue disorders (Ehlers-Danlos syndrome), twinning, and use of assisted reproductive technologies. These cases prompted us to review our exploratory laparotomies performed for intestinal obstruction, complicated/or not with perforation, to identify the frequency of neonatal trans-mesenteric hernias in a referral hospital. The prevalence of GIP and of internal hernia was 25% and 3.3%, respectively. In conclusion, time-onset and particular conditions associated with GIP should lead to a high index of suspicion for internal hernias in order to achieve appropriate diagnosis and therapy. |
| first_indexed | 2024-12-11T06:00:22Z |
| format | Article |
| id | doaj.art-b4aa4594a4b8413b9f14f2963348a04d |
| institution | Directory Open Access Journal |
| issn | 2213-5766 |
| language | English |
| last_indexed | 2024-12-11T06:00:22Z |
| publishDate | 2016-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Case Reports |
| spelling | doaj.art-b4aa4594a4b8413b9f14f2963348a04d2022-12-22T01:18:31ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662016-05-018C101210.1016/j.epsc.2016.03.004Early intestinal perforation secondary to congenital mesenteric defectsIngrid Anne Mandy Schierz0Mario Giuffrè1Mariaserena Lo Presti2Giuseppa Pinello3Cinzia Chiaramonte4Enrica Maria Agosta Cecala5Giovanni Corsello6Unità Operativa Complessa di Neonatologia e Terapia Intensiva Neonatale, Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Via Alfonso Giordano, 3, 90127 Palermo, ItalyUnità Operativa Complessa di Neonatologia e Terapia Intensiva Neonatale, Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Via Alfonso Giordano, 3, 90127 Palermo, ItalyUnità Operativa Complessa di Neonatologia e Terapia Intensiva Neonatale, Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Via Alfonso Giordano, 3, 90127 Palermo, ItalyUnità Operativa Complessa di Neonatologia e Terapia Intensiva Neonatale, Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Via Alfonso Giordano, 3, 90127 Palermo, ItalyUnità Operativa di Chirurgia Pediatrica, Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Via Alfonso Giordano, 3, 90127 Palermo, ItalyUnità Operativa di Chirurgia Pediatrica, Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Via Alfonso Giordano, 3, 90127 Palermo, ItalyUnità Operativa Complessa di Neonatologia e Terapia Intensiva Neonatale, Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Via Alfonso Giordano, 3, 90127 Palermo, ItalyGastrointestinal perforation (GIP) in preterm neonates may be idiopathic, due to necrotizing enterocolitis (NEC), or mechanical obstruction. The predominant cause of GIP in the neonatal period is NEC. Differential diagnosis with congenital malformations, including mesenteric defects leading to internal hernias, is mandatory if the onset is early. We describe two newborns with trans-mesenteric herniation resulting in GIP, and we discuss the presence of possible additional risk factors such as prematurity and predisposing vascular disruption in connective tissue disorders (Ehlers-Danlos syndrome), twinning, and use of assisted reproductive technologies. These cases prompted us to review our exploratory laparotomies performed for intestinal obstruction, complicated/or not with perforation, to identify the frequency of neonatal trans-mesenteric hernias in a referral hospital. The prevalence of GIP and of internal hernia was 25% and 3.3%, respectively. In conclusion, time-onset and particular conditions associated with GIP should lead to a high index of suspicion for internal hernias in order to achieve appropriate diagnosis and therapy.http://www.sciencedirect.com/science/article/pii/S2213576615300439Internal herniaDorsal mesenteryEhlers-Danlos syndromeTwin |
| spellingShingle | Ingrid Anne Mandy Schierz Mario Giuffrè Mariaserena Lo Presti Giuseppa Pinello Cinzia Chiaramonte Enrica Maria Agosta Cecala Giovanni Corsello Early intestinal perforation secondary to congenital mesenteric defects Journal of Pediatric Surgery Case Reports Internal hernia Dorsal mesentery Ehlers-Danlos syndrome Twin |
| title | Early intestinal perforation secondary to congenital mesenteric defects |
| title_full | Early intestinal perforation secondary to congenital mesenteric defects |
| title_fullStr | Early intestinal perforation secondary to congenital mesenteric defects |
| title_full_unstemmed | Early intestinal perforation secondary to congenital mesenteric defects |
| title_short | Early intestinal perforation secondary to congenital mesenteric defects |
| title_sort | early intestinal perforation secondary to congenital mesenteric defects |
| topic | Internal hernia Dorsal mesentery Ehlers-Danlos syndrome Twin |
| url | http://www.sciencedirect.com/science/article/pii/S2213576615300439 |
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