An Infant With Ischemic Colon Stenosis Due to Local Circulatory Disturbance in a Background of Congenital Heart Disease

Kamata Yuko, Mizuno Yuki, Okamoto Kentaro, Ueki Satono, Nishigata Aya, Matsuoka Kentaro

doi:10.11164/jjsps.59.6_997

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先天性心疾患を背景として，局所の循環障害から虚血性高度結腸狭窄を来した1乳児例
センテンセイシンシッカンオハイケイトシテ,キョクショノジュンカンショウガイカラキョケツセイコウドケッチョウキョウサクオキタシタ 1 ニュウジレイ

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Abstract

<p>We report the case of a three-month-old boy who underwent pulmonary artery banding at 24 days of age and cardiac catheterization at 61 days of age for ventricular septal defect, after which, he had repeated CRP level elevations. A contrast-enhanced CT scan showed partial wall thickening of the ascending colon, and a gastrointestinal contrast study suggested intestinal malrotation and ascending colon stenosis; thus, we performed laparotomy at 100 days of age. Intraoperatively, wall redness and thickening in the ascending colon were observed, in which severe stenosis was revealed by colonoscopy; thus, we additionally performed partial colon resection. Postoperatively, CRP became negative and never elevated. A histopathological examination revealed severe inflammation, ulceration, and ischemic changes in the stenotic area, suggesting that the colon stenosis was caused by chronic ischemia. We found that 14 of the 17 reported cases of infantile colon stenosis with ischemia that was not caused by necrotizing enterocolitis occurred after cardiovascular events such as cardiac surgery or cardiac resuscitation. Although the causal relationship is unclear, since the symptoms in this case became apparent after cardiac surgery and catheterization, it is also possible that these events were related in some way to intestinal ischemia.</p>

Journal

Journal of the Japanese Society of Pediatric Surgeons

Journal of the Japanese Society of Pediatric Surgeons 59 (6), 997-1003, 2023-10-20

The Japanese Society of Pediatric Surgeons

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