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PP-096 Ileal atresia in a newborn a rare case: cystic fibrosis
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  1. Hasan Avşar1,
  2. Sedanur Çelik2,
  3. Ebru Türkoğlu Ünal1,
  4. Adil Umut Zübarioğlu1,
  5. İlker Gönen1,
  6. Ali Bülbül1,
  7. Hasan Sinan Uslu1
  1. 1S.B.Ü Şişli Hamidiye Etfal Training and Research Hospital, Newborn Clinic, İstanbul
  2. 2S.B.Ü Şişli Hamidiye Etfal Training and Research Hospital, Child Health and Diseases Clinic, İstanbul

Abstract

Aim A newborn case diagnosed with cystic fibrosis, in which bowel dilatation was detected on ultrasonography during antenatal follow-up, meconium plug and intestinal atresia were subsequently detected, is presented due to its rarity.

Material and Method A female baby born to a 33-year-old mother via cesarean section with meconium due to prolonged membrane rupture and NST disruption at 33+5 gestational weeks was admitted to the neonatal intensive care unit due to respiratory distress. Non-invasive mechanical ventilation treatment was started. In the physical examination of the patient, no pathology was detected except intercostal and subcostal retraction. Antibiotherapy treatment was started due to preterm premature rupture of membranes (PPROM). During the prenatal follow-up, it was learned that antenatal ultrasonography revealed advanced dilatation starting from the upper segment of the intestine and that cystic fibrosis may be at the forefront. Following the 48th hour of follow-up, the patient did not pass stool, and direct abdominal X-ray was taken while standing, the pediatric surgeon was consulted. Distal colon radiography was taken by the surgeon. Meconium ileus?Atresia?Laparotomy was performed with the diagnosis. During the operation, a total of 7 atresic areas in different intestinal regions were observed and resected, followed by anastomosis. Genetic analysis was sent for cystic fibrosis mutation. Postoperatively, the patient‘s oral intake was maintained with minimal enteral nutrition. The child was evaluated by surgeon with examination and control radiographs. On the 32nd postnatal day, her general condition was good and she tolerated oral feeding, so she was discharged to the outpatient clinic for follow-up. The patient‘s genetic result was found to be CTFR heterozygous positive.

Results .

Conclusions In neonatal period, cystic fibrosis may present with gastrointestinal findings such as delayed meconium passage, intestinal atresia, volvulus and intestinal perforation. Patients with increased intestinal echogenicity and dilatation detected during ultrasonographic examination during the antenatal period should be monitored and examined for cystic fibrosis.

  • cystic fibrosis
  • intestinal atresia
  • meconium

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