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Lipomyelomeningocele Associated with Necrotizing Enterocolitis in a Term Neonate

足月新生兒脂肪脊髓髓膜膨出併壞死性腸炎:一病例報告

摘要


壞死性腸炎為新生兒加護病房最常見的腸胃急症。足月新生兒之壞死性腸炎占所有壞死性腸炎病例的5%到25%。脊髓髓膜膨出曾被認為是足月新生兒壞死性腸炎的一項危險因數。我們報告一位六天大的女性足月新生兒,於出生後即發現背部薦區脂肪脊髓髓膜膨出並經核樣共振攝影證實。病患於第四天大時,發生壞死性腸炎。臨床表現包括血便及腹脹,腹部X光攝影顯現空氣於腸壁及肝門靜脈。緊急開腹手術發現廣泛性腸壞死病變。雖然實行空腸造手術及給予廣汎性抗生素治療,但此病人仍於手術兩天後逝世。壞死性腸炎與脂肪脊髓髓膜膨出的相關性將予以討論。

並列摘要


A six-day-old full-term female infant with lipomyelomeningocele, confirmed by magnetic resonance imaging, suffered from necrotizing enterocolitis (NEC) when he was four-day-old. The clinical presentations were bloody stool and abdominal distension. A plain abdominal film demonstrated pneumatosis intestinalis and air in the portal vein. An emergent laparotomy was performed and revealed diffuse gangrenous change of both small and large bowels. A jejunostomy was done and strong antibiotics were given, but the baby died two days after the operation. In this paper report, the relation between lipomyelomeningocele and NEC is discussed.

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