A Case Report of Colonic Atresia that Presented after Necrotizing Enterocolitis Surgery in a ELBW Neonate

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A 15-day-old premature female neonate weighing 712 g (gestation: 28 weeks and 4 days) was diagnosed as having necrotizing enterocolitis based on clinical signs and results of an abdominal X-ray. Because conservative therapy was not effective, surgery was performed when the patient was 18 days old. Approximately 20 cm of necrosis was found near the terminal ileum, and an ileostomy was performed. Since post-operative recovery was normal, the fistulae were closed at 7 months post-birth. However, an ileus developed on day 17 after closure. Diamond anastomosis was then performed to treat the colonic atresia at the descending colon. Six days after the procedure, panperitonitis due to sutural insufficiency developed. Another ileostomy was performed, and the fistulae were closed 6 months later. The patient recovered and was discharged two months later. Currently, only 11 reports regarding colonic atresia after necrotizing enterocolitis exist. It is important to consider the possibility of colonic stricture or atresia at the distal gastrointestinal tract and to perform a thorough study of the intestine before closing fistulae.
日本腹部救急医学会の論文