輪状膵に伴った新生児胃Impending rupture の1例

概要

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A 3-day-old male neonate was referred to this hospital presenting with frequent vomiting and abdominal distension. He had passed only a small quantity of mucous stool since birth. Physical examination revealed marked abdominal distension and absence of bowel sounds, and approximately 60 ml of greenish yellow fluid mixed with 30 ml of air was aspirated through the intragastric tube. An upright X-ray film of the abdomen revealed a markedly distended stomach and a minimal amount of gas located distal to the pylorus. On Ba-enema in a supine position, a vast amount of irregularly overlapped intragastric air was noticed, by which the microcolon was displaced to the caudal. An emergency operation revealed a markedly distended stomach associated with a slight dilatation of the duodenum. Annular pancreas was detected, and a seromuscular tear with a length of 11 cm in the posterior wall along the greater curvature was extended from fundus to distal body, part of the gastric mucosa being herniated through this defect. The defect was repaired with 2 layers seromuscular sutures without mucosal resection. The patient'srecovery was uneventful. Impending rupture of the stomach in the newborn was discussed, and a large, irregularly overlapped, abnormal intragastric shadow was considered as an important finding of impen-ding rupture of the stomach in the newborn.
日本小児外科学会の論文
1987-05-20