Massive pulmonary gas embolism in a neonate with ileal atresia and meconium peritonitis.
We presented the case of a neonate with portal venous gas and pulmonary gas embolism. The patient presented with severe respiratory distress and abdominal distension 12 hours after birth. An ultrasound revealed intravascular microbubbles moving into a pulmonary artery that were traveling from the portal venous system through a ductus venosus. Additional clinical observations were hypotension and a sudden decrease in end-tidal carbon dioxide with a markedly discrepant high Pco(2), indicating a massive pulmonary gas embolism. Operative findings revealed congenital ileal atresia and meconium peritonitis with abscess. Gas-forming Escherichia coli was recovered from the abscess contents. The patient had respiratory distress, shock, disseminated intravascular coagulation, and intractable diarrhea but eventually recovered and was discharged on the 131st postoperative day.
Sato
Takashi
T
Division of Neonatology, Perinatal Medical Center, Niigata-City General Hospital, Niigata, Japan. satot@hosp.niigatga.niigata.jp
Nitta
Koju
K
Iinuma
Yasuhumi
Y
Komori
Toshie
T
Naito
Shinichi
S
Saikusa
Nobuyuki
N
Haniu
Hisanori
H
Yamazaki
Hajime
H
Hoshina
Satoshi
S
Ooishi
Masanori
M
Nagayama
Yosihisa
Y
D004618:Embolism, Air / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D007082:Ileum / Q000002:abnormalities*; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008470:Meconium; D010538:Peritonitis / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D011169:Portal Vein; D011655:Pulmonary Embolism / Q000150:complications* / Q000175:diagnosis / Q000601:surgery