• A case of small bowel obstruction of a rare etiology in a newborn with gastroschisis
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A case of small bowel obstruction of a rare etiology in a newborn with gastroschisis

Paediatric Surgery.Ukraine.2017.2(55):27-31; doi 10.15574/PS.2017.55.27

Sliepov O. K., Migur M. Yu., Gordienko I. Yu., Ponomarenko O. M., Tarapurova O. M., Palkina I. S.
SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine», Kyiv

Gastroschisis (GS) in a fetus was diagnosed by prenatal ultrasonography (US) at a period of 28 weeks of gestation. Prenatal US follow-up monitoring and examinations were conducted. The delivery was performed by a planned preterm cesarean section at 36-37 weeks of gestation. Surgical treatment of GS was performed in 15 minutes after birth, according to the tactics «Surgery of the first minutes», developed in our clinic. During the primary operative intervention, unobliterated omphalomesenteric vessel caused a small bowel obstruction (SBO) was discovered and removed. On 14th day after the primary operation, the child was reoperated because of the partial intestinal obstruction symptoms. During the reoperation, the functional obstruction of the small intestine in the site of a previously removed omphalomesenteric vessel was revealed. A resection of 10.0 cm of the ileum with a narrowing segment was performed and an anastomosis end-to-end was created. Recurrence of the intestinal obstruction after the surgery was not observed, complete enteral nutrition was achieved. The effect of the performed step operations is good.

Conclusions. Proposed surgical tactics and strategy of complicated GS associated with partial SBO was effective and can be used in cases of ileum obstruction caused by an aberrant omphalomesenteric vessel.

Key words: gastroschisis, omphalomesenteric vessel, compression of small intestine, surgical treatment, infant


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