腸間膜裂孔ヘルニアにより消化管穿孔を生じた超低出生体重児の1例  [in Japanese] Transmesenteric Hernia in Extremely Low Birth Weight Infant: Case Report and Literature Review  [in Japanese]

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Author(s)

    • 石井 惇也 Ishii Junya
    • 順天堂大学医学部附属浦安病院小児外科 Departments of Pediatric Surgery, Juntendo University Urayasu Hospital
    • 山田 進 Yamada Susumu
    • 順天堂大学医学部附属浦安病院小児外科 Departments of Pediatric Surgery, Juntendo University Urayasu Hospital
    • 大日方 薫 Obinata Kaoru
    • 順天堂大学医学部附属浦安病院小児科 Departments of Pediatrics, Juntendo University Urayasu Hospital

Abstract

<p>症例は,切迫早産にて在胎24週2日緊急帝王切開で院内分娩となった女児.出生時体重539 g.直ちにNICU入院.日齢4より母乳での経腸栄養を開始した.日齢7より腹部膨満が出現し,日齢9の腹部X線にて腹腔内遊離ガス像を認めたため,緊急手術を施行した.開腹すると径1.5 cm大の回腸腸間膜欠損孔へ回腸が嵌入した腸間膜裂孔ヘルニアで,穿孔部位は嵌入腸管で回腸末端より5 cm口側の位置であった.穿孔部を含め血行障害を呈していた回腸約20 cmを切除し,単孔式回腸瘻を造設した.日齢188に回腸瘻閉鎖術を施行し,術後順調に経過している.腸間膜裂孔ヘルニアは稀な疾患であるが,超低出生体重児の腹部膨満,腸閉塞症状の病態では本疾患も念頭において対応する必要がある.</p>

<p>An extremely low birth weight female infant was born after 24 weeks of gestation by cesarean section. Her birth weight was 539 g and her Apgar scores were 3 in 1 min and 6 in 5 min. Enteral feeding was started at 4 days of age through a nasogastric tube. Abdominal distension developed from 7 days of age, and abdominal X-ray showed free air on the 9th day of age. Emergency laparotomy was performed and a diagnosis of transmesenteric hernia was made. Twenty centimeters of necrotic ileum was resected and ileostomy was created. Her postoperative course was uneventful and ileostomy was closed on the 188th day of age. Herein, we report a rare case of transmesenteric hernia in an extremely low birth weight infant with a literature review.</p>

Journal

  • Journal of the Japanese Society of Pediatric Surgeons

    Journal of the Japanese Society of Pediatric Surgeons 55(1), 95-98, 2019

    The Japanese Society of Pediatric Surgeons

Codes

  • NII Article ID (NAID)
    130007602194
  • NII NACSIS-CAT ID (NCID)
    AN00192281
  • Text Lang
    JPN
  • ISSN
    0288-609X
  • NDL Article ID
    029549284
  • NDL Call No.
    Z19-244
  • Data Source
    NDL  J-STAGE 
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