A rare case of neonatal ileo-cecal valve stenosis due to covered iliac perforation.
At birth, newborn babies tend to respond to any stressful event with elective blood shunting towards the main organ systems, such as the brain and heart. Consequently, the bowel may suffer from a severe flow reduction with a high risk of hypoperfusion. The distal ileum is relatively less vascularized than other parts of intestine, due to a lack of collateral arteriolar circulation. It is therefore at higher risk of hypoxia, tissue necrosis and perforation in situations of minimal hypoperfusion or spasm. A rare case of covered perforation of the last loop of the ileum in a severely preterm baby is reported. The perforation manifested atypically as inflammatory stenosis of the loop and the ileo-cecal valve. To avoid misdiagnoses and to manage these cases correctly, the caregiver has to consider this rare eventuality in the differential diagnosis of intestinal occlusion/subocclusion in the first days of life.
Messina
Mario
M
Section of Pediatric Surgery, Department of Pediatrics, Obstretrics and Reproductive Medicine, Policlinico Le Scotte, University of Siena, Viale Bracci, I-53100 Siena, Italy. messinam@unisi.it
Ferrucci
Elisabetta
E
Garzi
Alfredo
A
Meucci
Daniela
D
Buonocore
Giuseppe
G
D003251:Constriction, Pathologic; D004868:Equipment Failure; D006801:Humans; D007080:Ileocecal Valve; D007082:Ileum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D007231:Infant, Newborn; D007234:Infant, Premature; D007416:Intestinal Perforation / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011859:Radiography