新生児原発性小腸軸捻転症の３例

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  • THREE CASES OF PRIMARY SMALL BOWEL VOLVULUS IN NEONATES

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The volvulus occurred in three male neonates in an early neonatal period within day 2. Their birth weights ranged from 2286g to 1500g and all of them were low-birth-weight infants. Abdoninal distension was recognized in all cases. A coffee-like emesis was found in case 1, and respiratory disturbance in case 3. Barium enema study disclosed no dislocation of the colon. Laparotomy showed that the distal ileum was twisted clockwise by 360° and the color of the affected portion of intestine was normalized by repositioning in case 1 and 2. In case 3, the proximal part of the jejunum was stangulated in the direction of 720°counter-clockwise, and a partial bowel necrosis was found which required bowel resection.<br> Although no definite diagnosis could be made in all three cases preoperatively, their lives were saved by performing laparotomy in an early stage, because they had marked dilatation of the small intestine as well as intestinal obstruction which resisted being reduced by conservative therapy.

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