| 摘要 |
The most common cause of intestinal perforation in the neonate is necrotizing enterocolitis (NEC). It occurs mostly in the neonate who is premature and has a low birth weight. Focal intestinal perforation (FIP), which is also frequently seen in the premature or small neonate, is an emerging disease entity which is not associated with NEC. It lacks the classic features of NEC such as abdominal distention, pneumatosis intestinalis and gas in the portal vein. We report an extremely-low-birth-weight (ELBW) permature baby, 26 weeks gestation age, 587 gm, with abdominal distention and pneumoperitoneum, with FIP finally being diagnosed. Initial management included peritoneal drainage and followed by laparotomy after the condition stabilized. The postoperative course was uneventful.
At the time of surgery the baby’s weight was 489 gm. Reviewing the English medical references, this is the smallesr surviving patient receiving such abdominal surgery. The key factors in a successful abdominal surgery for ELBW premature baby may ibclude (1) improved premature baby team care (by neonatologist, pediatric surgeon and pediatric anesthesiologist); (2) better biochemical equipments for ELBW care; (3) more experience of pediatric surgeons; and (4) more sophisticated instruments for neonatal surgery. |
