新生児消化管穿孔 : とくにエンドトキシン血症を中心として

概要

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We performed the Limulus test (L-test) to evaluate endotoxemia in 14 patiets who had gastrointestinal perforations (7 gastric and 7 intestinal) in the neonatal period, and had the following results : 1) Eight (3 gastric and 5 intestinal) of the 14 cases (57.1%) were diagnosed as the endotoxemia by the positive result of L-test. 2) The L-test-positive cases showed high mortality ; five patients in 14 boses died (62.5%), but the L-test-negative cases were all survived, so that the endotoxin may greatly affect on the prognosis of these cases. 3) In all autopsy cases (5 cases), hemorrhage was observed in various organs, such as the lung, kidney, adrenal gland and gastrointestinal tract, however, thrombi were detected histologically in two of three cases who had been clinically diagnosed as disseminated intravasular coagulation. Thus, we think that L-test is essential evaluation of clinical course and prognosis of the patients with gastrointestinal perforation in the neonatal period.
日本小児外科学会の論文
1986-05-20