Clot dissolution: a novel treatment of midgut volvulus.
Midgut volvulus due to malrotation may result in loss of the small bowel. Until now, after derotation of the volvulus, pediatric surgeons do not deal with the mesenteric thrombosis, which causes continuing ischemia of the intestine. On occasion, a "second look" laparotomy is performed in the hope that some improvement in blood supply to the intestine has occurred. We describe a new combined treatment to restore intestinal perfusion based on digital massage of the superior mesenteric vessels after derotation and systemic infusion of tissue-type plasminogen activator. This new therapy has been successful in 2 neonates with severe intestinal ischemia due to volvulus.
Great Ormond Street Hospital for Children National Health Service Trust, London, United Kingdom.
Edward M
EM
Kiely
Agostino
A
Pierro
Christine
C
Pierce
Kate
K
Cross
Paolo
P
De Coppi
D004386:Duodenum / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007082:Ileum / Q000473:pathology* / Q000601:surgery; D007231:Infant, Newborn; D045822:Intestinal Volvulus / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*; D007583:Jejunum / Q000473:pathology* / Q000601:surgery; D008297:Male; D061185:Mechanical Thrombolysis / Q000379:methods; D015912:Thrombolytic Therapy / Q000379:methods; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D010959:Tissue Plasminogen Activator