新生児期に発症した慢性特発性仮性腸閉塞症 (CIIPS) の1例

概要

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A-1-month old female infant was admitted to this hospital with the primary complaint of abdominal distension and vomiting. Although intestinal X-ray series revealed diffusely distended colon, caliber change was not observed. Cystography revealed dilation of the bladder and urinary retention 78ml was observed by catheterization. Recto-anal reflex was present. Biopsy of the rectum revealed mature ganglion cells, while acetyl-cholinesterase steining did not reveal increased formation of nerve fibers. Upper intestinal manometric study revealed decreased number of contractions and decreased pressure at the 2nd portion of the doudenum, but did not reveal phase 3 interdigestive motor complex. Nutrition of the infant was managed by intravenous hyperalimentation and oral intake of elemental diet. In addition, colonic irrigation was performed to prevent the occurrence of enteritis using a tube inserted in the descending colon per anus. Although the infant is presently one year old and is demonstrating favorable physical and mental development, oral ingestion other than elemental diet is not possible yet. Oral administration of cisapride (0.3mg/kg/day) was ineffective.
日本小児外科学会の論文
1992-12-20