内臓逆位症を伴った腹部奇形 : 2症例の報告と本邦報告例の検討

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Although situs inversus (SI) is rare, it is recognized' as an important condition since a number of anomalies are associated with it. In this paper, we report 2 cases of neonatal SI associated with abdominal malformation and review the literature of SI discovered in early infancy. Case 1: A one-day-old, full term, 2,800g, male was admitted with the complaint of tachypnea. A thoraco-abdominal X-ray film demonstrated a rt. diaphragmatic hernia and dextrocardia. He underwent repair of the diaphragmatic hernia (the size of the hernia was 3.8cm by 3.8cm) and Ladd's procedure for the malrotation. The postoperative diagnosis was rt. diaphragmatic hernia and malrotation associated with SI and dextrocardia. Presentrly, at the age of 11 months, he is developing normally. Case 2: A nine-day-old, full term, 3,070g, female was admitted with the complaint of vomiting. A thoraco-abdominal plain film demonstrated dextrocardia and dilatation of duo-denum. The diagnosis of duodenal stenosis was made by the upper GI series and she underwent a duodeno-jejunostomy. She was discharged in satisfactory condition on the 25th postoperative day. We collected 28 cases of intra-abdominal anomalies associated with SI in children less than 1-year-old, including our cases, in Japan. In a literature review, intra-abdominal anomalies were found as follows: malrotation in 15 cases, congenital biliary atresia in 11, preduodenal portal vein in 7, polysplenia in 7, diaphragmatic hernia in 4, annular pancreas in 4, asplenia in 3, duodenal atresia in 2 and duodenal stenosis in 2. When situs in versus is recongnized in early infancy, the examinations of the GI tract, biliary tract and portal vein as well as a search of cardiac anomaly are specialy recommended for making a prompt and accurate diagnosis.
日本小児外科学会の論文
1986-06-20

内臓逆位症を伴った腹部奇形 : 2症例の報告と本邦報告例の検討

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