Virtual Pediatric Hospital: Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology: Case 38
Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology
Michael P. D'Alessandro, M.D.,
Steven J. Fishman, M.D.,
Deborah E. Schofield, M.D.
Peer Review Status: Internally Peer Reviewed
Chief Complaint: Eighteen day old former 27 week premature female with abdominal distension and rapid clinical deterioration.
Clinical History: The patient was a former 27 week premature female, now 18 days old. In the last 8 hours the patient underwent rapid clinical deterioration, developing abdominal distension and going from a non ventilated state to requiring high frequency ventilation. Ventilation was very difficult, secondary to the abdominal distension.
Operative Findings: The patient was taken emergently to the operating room for an exploratory laparotomy through a transverse umbilical incision. Cloudy fluid was encountered. The bowel was noted to be white and necrotic throughout its entire length from the duodenum to the colon. Total necrosis of the intestines was seen, secondary to necrotizing enterocolitis. There was no salvageable bowel. The abdomen was closed.
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