Difficulty in diagnosis and management of postoperative colostomy-related complications n a very low birthweight infant

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  • Tsunokake Kazune
    Department of Pediatrics, School of Medicine, Iwate Medical University, Yahaba, Japan
  • Toya Yukiko
    Department of Pediatrics, School of Medicine, Iwate Medical University, Yahaba, Japan
  • Kobayashi Megumi
    Department of Surgery, School of Medicine, wate Medical University, Yahaba, Japan
  • Matsumoto Atsushi
    Department of Pediatrics, School of Medicine, Iwate Medical University, Yahaba, Japan
  • Akasaka Manami
    Department of Pediatrics, School of Medicine, Iwate Medical University, Yahaba, Japan

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Other Title
  • 腸重積の診断と術後人工肛門関連合併症の管理が困難であった超低出生体重の女児例
  • チョウジュウ セキ ノ シンダン ト ジュツゴ ジンコウコウモン カンレン ガッペイショウ ノ カンリ ガ コンナン デ アッタ チョウテイシュッショウ タイジュウ ノ ジョジレイ

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Abstract

A girl weighing 322 g was born at 23 weeks of gestation by emergency cesarean section due to cardiac failure caused by maternal hypertension. She had delayed fecal excretion and abdominal distension, and developed gastrointestinal perforation on the eighth day of life. The baby was treated conservatively due to prematurity, and a colostomy was performed at 36 days of age. The postoperative diagnosis was intestinal distension caused by true diverticula. Enteral feeding was resumed after the operation, but at 90 days of age the stoma was inverted and prolapsed. Although manual repair was performed, the respiratory and circulatory dynamics gradually deteriorated with repeated prolapses and she died at 95 days of age. Intestinal intussusception in neonates is rare and difficult to diagnose pre-operatively because of its nonspecific symptoms. Proctocolectomy in extremely low birthweight infants is a difficult procedure with many complications.

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