BACKGROUND Congenital intestinal malrotation(CIM)is a common malformation in neonates.Early diagnosis and surgical intervention can improve the prognosis.CIM combined with congenital gastric wall defect is a potential...BACKGROUND Congenital intestinal malrotation(CIM)is a common malformation in neonates.Early diagnosis and surgical intervention can improve the prognosis.CIM combined with congenital gastric wall defect is a potentially fatal condition.We present a severe case of CIM with gastric wall defect causing extensive gut necrosis and short gut syndrome.After three operations,the neonate survived and subsequently showed normal growth and development during infancy.CASE SUMMARY A male neonate(age:4 d)was hospitalized due to bloody stools and vomiting for 2 d,and abdominal distention for 1 d.Emergent exploratory laparotomy revealed black purplish discoloration of the bowel loops.Bowel alignment was abnormal with congestion and dilatation of the entire intestine,and clockwise mesentery volvulus(720°).The posterior wall of the gastric body near the greater curvature showed a defect in the muscularis layer(approximately 5.5 cm),and a circular perforation(approximately 3 cm diameter)at the center of this defect.Ladd’s procedure was performed and gastric wall defect was repaired.Third operation performed 53 d after birth revealed extensive adherence of small intestine and peritoneum,and adhesion angulated between many small intestinal loops.We performed intestinal adhesiolysis,resection of necrotic intestine,and small bowel anastomosis.CONCLUSION This case highlights that prolonged medical treatment may help improve intestinal salvage after surgical removal of necrotic intestines,and improve patient prognosis.展开更多
BACKGROUND Meckel's diverticulum is a common congenital anomaly of the gastrointestinal tract,with a higher incidence rate in children under 7 years old.The condition is characteristically asymptomatic but may bec...BACKGROUND Meckel's diverticulum is a common congenital anomaly of the gastrointestinal tract,with a higher incidence rate in children under 7 years old.The condition is characteristically asymptomatic but may become a clinical concern when complications such as intestinal obstruction,bleeding,perforation,or diverticulitis precipitate acute abdominal presentations.CASE SUMMARY This report describes the case of a middle-aged man initially suspected of having acute appendicitis,which rapidly progressed to acute peritonitis with concomitant intestinal obstruction observed during preoperative assessment.Surgical exploration confirmed the diagnosis of Meckel's diverticulum-induced internal hernia,accompanied by intestinal obstruction and necrosis.In addition,the hernial ring base exhibited entrapment resembling a surgical knot.CONCLUSION Meckel's diverticulum is a rare cause of small bowel obstruction in adults,and it should be considered in a differential diagnosis.展开更多
文摘BACKGROUND Congenital intestinal malrotation(CIM)is a common malformation in neonates.Early diagnosis and surgical intervention can improve the prognosis.CIM combined with congenital gastric wall defect is a potentially fatal condition.We present a severe case of CIM with gastric wall defect causing extensive gut necrosis and short gut syndrome.After three operations,the neonate survived and subsequently showed normal growth and development during infancy.CASE SUMMARY A male neonate(age:4 d)was hospitalized due to bloody stools and vomiting for 2 d,and abdominal distention for 1 d.Emergent exploratory laparotomy revealed black purplish discoloration of the bowel loops.Bowel alignment was abnormal with congestion and dilatation of the entire intestine,and clockwise mesentery volvulus(720°).The posterior wall of the gastric body near the greater curvature showed a defect in the muscularis layer(approximately 5.5 cm),and a circular perforation(approximately 3 cm diameter)at the center of this defect.Ladd’s procedure was performed and gastric wall defect was repaired.Third operation performed 53 d after birth revealed extensive adherence of small intestine and peritoneum,and adhesion angulated between many small intestinal loops.We performed intestinal adhesiolysis,resection of necrotic intestine,and small bowel anastomosis.CONCLUSION This case highlights that prolonged medical treatment may help improve intestinal salvage after surgical removal of necrotic intestines,and improve patient prognosis.
文摘BACKGROUND Meckel's diverticulum is a common congenital anomaly of the gastrointestinal tract,with a higher incidence rate in children under 7 years old.The condition is characteristically asymptomatic but may become a clinical concern when complications such as intestinal obstruction,bleeding,perforation,or diverticulitis precipitate acute abdominal presentations.CASE SUMMARY This report describes the case of a middle-aged man initially suspected of having acute appendicitis,which rapidly progressed to acute peritonitis with concomitant intestinal obstruction observed during preoperative assessment.Surgical exploration confirmed the diagnosis of Meckel's diverticulum-induced internal hernia,accompanied by intestinal obstruction and necrosis.In addition,the hernial ring base exhibited entrapment resembling a surgical knot.CONCLUSION Meckel's diverticulum is a rare cause of small bowel obstruction in adults,and it should be considered in a differential diagnosis.
