title: A rare case of neonatal ileo-cecal valve stenosis due to covered iliac perforation.
abstract: 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.
authors.affiliation: 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
authors.forename: Mario
authors.initials: M
authors.lastname: Messina
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Ferrucci
authors.forename: Alfredo
authors.initials: A
authors.lastname: Garzi
authors.forename: Daniela
authors.initials: D
authors.lastname: Meucci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Buonocore
mesh_terms: 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