Intussusception in Neonates: Clinical Characteristics of Eight Cases in a Single Center
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Intussusception is the most common cause of bowel obstruction in children; however, it is rarely diagnosed in newborn infants. This study aimed to describe the clinical features of intussusception in newborn infants. Methods: Medical records of eight patients diagnosed with intussusception during the newborn period at Ulsan University Hospital between March 2007 and March 2020 were retrospectively reviewed. Results: Among the eight cases, two occurred in the intrauterine period and six occurred in the postnatal period. Intrauterine intussusception presented with symptoms of bowel obstruction within 1 to 2 days after birth, and ileal atresia was diagnosed simultaneously through exploratory laparotomy. All the postnatal patients were extremely low birth weight infants (median gestational age and birth weight: 25+6 weeks and 745 g, respectively). Four cases were diagnosed preoperatively using abdominal ultrasonography. One patient was diagnosed by exploratory laparotomy because the clinical symptoms were nonspecific and difficult to differentiate from those of necrotizing enterocolitis, a more prevalent complication in preterm infants. The site of intussusception in all six patients was the small bowel. Meckel’s diverticulum (one case) and meconium obstruction (two cases) were found to be the lead point. Conclusion: Neonatal intussusception tends to show different clinical features according to its period of occurrence. Intussusception, especially in preterm infants, has nonspecific clinical features; therefore, clinicians should always be cautious of this disease for its early diagnosis.
Abstract
Purpose: Intussusception is the most common cause of bowel obstruction in children; however, it is rarely diagnosed in newborn infants. This study aimed to describe the clinical features of intussusception in newborn infants. Methods: Medical records of eight patients diagnosed with intussusception during the newborn period at Ulsan University Hospital between March 2007 and March 2020 were retrospectively reviewed. Results: Among the eight cases, two occurred in the intrauterine period and six occurred in the postnatal period. Intrauterine intussusception presented with symptoms of bowel obstruction within 1 to 2 days after birth, and ileal atresia was diagnosed simultaneously through exploratory laparotomy. All the postnatal patients were extremely low birth weight infants (median gestational age and birth weight: 25+6 weeks and 745 g, respectively). Four cases were diagnosed preoperatively using abdominal ultrasonography. One patient was diagnosed by exploratory laparotomy because the clinical symptoms were nonspecific and difficult to differentiate from those of necrotizing enterocolitis, a more prevalent complication in preterm infants. The site of intussusception in all six patients was the small bowel. Meckel’s diverticulum (one case) and meconium obstruction (two cases) were found to be the lead point. Conclusion: Neonatal intussusception tends to show different clinical features according to its period of occurrence. Intussusception, especially in preterm infants, has nonspecific clinical features; therefore, clinicians should always be cautious of this disease for its early diagnosis.
참고문헌 (29)
- Maqbool A, "Nelson textbook of pediatrics", pp.1965~1967 (2020), Elsevier
- Rachelson MH, "Intussusception in the newborn infant with spontaneous expulsion of the intussusceptum; a case report and review of the literature", J Pediatr, 47, pp.87~94 (1955)
- Wang NL, "Prenatal and neonatal intussusception", Pediatr Surg Int, 13, pp.232~236 (1998)
- Ueki I, "Intussusception in neonates : analysis of 14 Japanese patients", J Paediatr Child Health, 40, pp.388~391 (2004)
- Patriquin HB, "Neonatal intussusception. Report of 12 cases", Radiology, 125, pp.463~466 (1977)
- 이보영, "미숙아에서 발견된 태생기 회장-회장형 장중첩증 1예", Pediatric Gastroenterology, Hepatology & Nutrition, 8(2), pp.247~251 (2005), 대한소아소화기영양학회
- Hong J, "Ileal Atresia due to intrauterine intussusception", J Korean Surg Soc, 52, pp.732~737 (1997)
- Huang WC, "A rare type of ileal atresia due to intrauterine intussusception", Eur J Pediatr, 166, pp.1177~1178 (2007)
- Imai Y, "Fusion of intussusceptum and intussuscipiens in intrauterine intussusception : a rare type of intestinal atresia", Pathol Int, 49, pp.962~967 (1999)
- Kim SC, "Intestinal atresia : the second national survey", J Korean Assoc Pediatr Surg, 16, pp.1~10 (2010)
- Martinez Biarge M, "Intussusception in a preterm neonate: a very rare, major intestinal problem. Systematic review of cases", J Perinat Med, 32, pp.190~194 (2004)
- Avansino JR, "Clinical features and treatment outcome of intussusception in premature neonates", J Pediatr Surg, 38, pp.1818~1821 (2003)
- Nock ML, "Intussusception in a premature neonate", Clin Pediatr(Phila), 41, pp.721~724 (2002)
- Gorgen-Pauly U, "Intussusception in preterm infants : case report and literature review", Eur J Pediatr, 158, pp.830~832 (1999)
- Mooney DP, "Perinatal intussusception in premature infants", J Pediatr Surg, 31, pp.695~697 (1996)
- Prakash A, "Intussusception in a premature neonate : a rare and often misdiagnosed clinical entity", Afr J Paediatr Surg, 12, pp.82~85 (2015)
- Taskinlar H, "Challenging diagnosis between intussusception and necrotizing enterocolitis in premature infants", Pediatr Int, 56, pp.e1~e3 (2014)
- Jiyoung Park, "Double Intussusceptions with Necrotizing Enterocolitis Diagnosed in a Premature Infant", Neonatal medicine, 22(4), pp.213~216 (2015), 대한신생아학회
- Yoo RP, "Intussusception in the newborn : a unique clinical entity", J Pediatr Surg, 9, pp.495~498 (1974)
- Shad J, "Ileo-colic intussusception in premature neonate", BMJ Case Rep, 2011, pp.bcr1120115~ (2011)
- Slam KD, "Multiple sequential intussusceptions causing bowel obstruction in a preterm neonate", J Pediatr Surg, 42, pp.1279~1281 (2007)
- Siddiqui MM, "Meconium obstruction of prematurity", Arch Dis Child Fetal Neonatal Ed, 97, pp.F147~F150 (2012)
- Kim YJ, "Recognition, diagnosis and treatment of meconium obstruction in extremely low birth weight infants", Neonatology, 101, pp.172~178 (2012)
- Starshak RJ, "Meconium plug syndrome associated with neonatal intussusception", Gastrointest Radiol, 6, pp.75~78 (1981)
- Takai A, "Ultrasonographic findings of multiple intussusception in an extremely preterm infant", Arch Dis Child, 104, pp.488~ (2019)
- Aydin E, "Intussusception in a preterm newborn", Pediatr Neonatol, 59, pp.312~314 (2018)
- Raza HA, "Diagnosing intussusception in preterm neonates : case report and overview", J Clin Neonatol, 3, pp.103~105 (2014)
- Wang Q, "Can intussusceptions of small bowel and colon be transient? A prospective study", Eur J Pediatr, 178, pp.1537~1544 (2019)
- 김지혜, "US Features of Transient Small Bowel Intussusception in Pediatric Patients", Korean Journal of Radiology, 5(3), pp.178~184 (2004), 대한영상의학회