- The first successful experience in Ukraine of surgical treatment of a 3-day-old neonate with mediastinal enterogenous cysts, complicated by tracheal compression and asphyxia
The first successful experience in Ukraine of surgical treatment of a 3-day-old neonate with mediastinal enterogenous cysts, complicated by tracheal compression and asphyxia
Paediatric Surgery.2017.3(56):10-15; doi 10.15574/PS.2017.56.10
Sliepov O., Ponomarenko O., Golopapa G.
SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS Ukraine», Kyiv
Enterogenous cysts are a congenital malformation of the primary intestine development, in the form of round or oval bulk formation, which lies paravertebral, along or behind the esophagus, or cystic doubling of the intestinal tube located in the mediastinum and retroperitoneum. In the world literature, there are isolated publications of the detecting and surgical treatment of enterogenous cysts of mediastinum in newborn babies. Moreover, they are related to the late neonatal period. In Ukraine, there are no such publications at all. We present a clinical case of the first successful surgical correction of symptomatic enterogenous cyst in a neonate in the early neonatal period.
Cyst of the right lung was diagnosed with prenatal ultrasound at 38 weeks of gestation period in the fetal medicine department of SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS Ukraine». The female patient was born in Obstetric Clinics of the Institute, from mother with premature removal of amniotic fluid, slight polyhydramnios, pathological birth, 40-41 weeks of gestational age at delivery, in severe asphyxia, with Apgar score of 5 points at the first minute and 4 points at the fifth minute of life. From the 2nd day of life, despite of the conservative treatment, the child’s general condition worsened due to the increased compression of the trachea, esophagus, right bronchus and lung, the inability of adequate independent breathing, even through the intubation tube. On the 3rd day of life an emergency operation was performed: right-sided thoracotomy, removal of cystic formation of mediastinum with decompression of the airways and esophagus (surgeon Prof. Slеpov O.). The presented rare case of the large complicated symptomatic enterogenous cyst in a newborn child and its successful early emergency surgical treatment are an example of a well-chosen tactic for the management of such complicated patients that can save life and, in the future, receive good functional results.
Key words: mediastinal cyst, complicated enterogenous cyst, newborns, surgical treatment.
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