新生児胃穿孔をきたした腹部内臓逆位症の1治験例

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  • A Newborn Case of Situs Inversus (levocardia) Associated with Gastric Perforation

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A four-day-old boy was transfered to Tsukuba University Hospital with abdominal distension due to perforation of the gastrointestinal tract. Chest and abdominal X-ray showed gastric perforation but there were several interesting findings. The stomach-bubble shadow was right sided with the gastric impending rupture. Three small mass shadows within intraabdominal free air were seen in the right region, indicating polysplenia. The cardiac shadow was in normal position suggesting left isomerism. The operative findings were just as suggested by preoperative diagnosis and simultaneously disclosed an annular pancreas causing duodenal stenosis, preduodenal portal vein and reversed rotation of the intestine. Direct suture closure of the gastric wall and duodenoduodenostomy were performed, and postoperative course was uneventful. Ultrasonography and MR images revealed PDA, VSD, IVC interruption, and azygos and hemiazygos continuation.

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