摘要
閉鎖是先天性腸阻塞最常見的原因，發生率占活產的五千郅萬分之一，懷孕期間腸道缺血是病變形成的主因。此篇所報病例是懷孕三十交週新生兒。在產前超音波發有擴張的腸環，出生時羊水過多含胎便而且由口鼻抽吸出兩百毫升羊水。理學檢查除了腹脹其餘正常。上腸胃道攝影顯示；顯彯劑二十四小時後仍無法通過腸胃道，而且積在上消化道。於是決定第三天進行剖腹手術。手術發現除空腸閉鎖第三型且閉鎖位置前有擴大的空腸，病理切片鏡檢發現也與臨床診斷吻合，經手術切除及端對端吻合術後，給與全靜脈營養。當開始食後，腹瀉含水便就被發現。糞便分析顯示中性脂及澱粉吸收不良。在長期食元素奶粉後，雖然體重在九個月前都小於三個百分比，但腹瀉情形已逐漸改善。我們認為慢性腹瀉可能起因於較長時間的腸胃道未使用及收不良有關。總計共費時約兩百七十天達到完全吸收而且不再腹瀉。
並列摘要
Atresia is the most common cause of congenital intestinal obstruction and its incidence ranges form one in 5,000 to one in 10,000 live births. It might result from an ischemic injury to the bowel during the pregnancy in the pathogenesis of this malformation. We report a case of 36-gestation-age neonate, who was born to a 34-year-old healthy mother. Dilated intestinal loops were revealed by prenatal ultrasonography during the last 5 weeks of pregnancy. At birth, polyhydramnios with meconium stain was noted, and 200mL amniotic fluid was aspirated from the stomach. Physical examination revealed a pinkish, active, crying infant with a distended abdomen. Upper gastrointestinal series were performed on the next day and showed static contrast medium at the jejunum that had not pass through the intestinal tract 24 hours later. Under the impression of jejunoileal atresia, laparotomy was performed on the 3rd with a dilated jejunum proximal to the atresia site. The pathological findings under a microscope were compatible with congenital atresia. After resection and end-to-end anastomosis, total parenteral nutrition was administered. Unfortunately, the neonate began to suffer from diarrhea when regular oralformula was given to her staring at the 7th week. Stool analysis revealed malabsorption of neutral fatand starch. After intake of Pregestimil, the symptom improved gradually although her body weight remained under the 3rd percentile until 9 months old. We thought her chronic diarrhea might have been caused by long-term disused atrophy and malabsorption by her intestine. It took her about 270 days for her to fully recover and for her chronic diarrhea to subside.