A rare case of neonatal ileo-cecal valve stenosis due to covered iliac perforation.

Section of Pediatric Surgery, Department of Pediatrics, Obstretrics and Reproductive Medicine, Policlinico Le Scotte, University of Siena, Viale Bracci, I-53100 Siena, Italy. messinam@unisi.it

At birth, newborn babies tend to respond to any stressful event with elective blood shunting towards the main organ systems, such as the brain and heart. Consequently, the bowel may suffer from a severe flow reduction with a high risk of hypoperfusion. The distal ileum is relatively less vascularized than other parts of intestine, due to a lack of collateral arteriolar circulation. It is therefore at higher risk of hypoxia, tissue necrosis and perforation in situations of minimal hypoperfusion or spasm. A rare case of covered perforation of the last loop of the ileum in a severely preterm baby is reported. The perforation manifested atypically as inflammatory stenosis of the loop and the ileo-cecal valve. To avoid misdiagnoses and to manage these cases correctly, the caregiver has to consider this rare eventuality in the differential diagnosis of intestinal occlusion/subocclusion in the first days of life. Copyright 2003 S. Karger AG, Basel

PMID: 12566687 [PubMed - indexed for MEDLINE]