Segmental dilatation of the interstine - case series of newborns with segmental dilatation of the small intestine and a literature review
Abstract
Introduction: Segmental dilatation of the intestine (SDI) is a rarely published disorder characterized by abnormal dilatation of one or more intestinal segments of normal diameter and transit both orally and aborally manifesting by functional obstruction of the intestines Methods: The retrospective case series study of patients treated at the Department of Pediatrics of University Hospital in Hradec Králové. Results: SDI was diagnosed in 22 patients.
All patiens were premature newborns; 19 (86%) of birth weight <1500 g, 15 of them (68% of all cases) of birth weight <1000 g. The median birth weigth was 815 g (680-2720 g), the median gestational age was 26 weeks (24-35 weeks).
SDI was slightly more frequently diagnosed in male newborns (male-to-female ratio - 13:9; i.e. 1.4:1). Clinical manifestations including abdominal distension, prominent bowel loops and feeding intolerance occured between day 1-14 of life (on the 5th day on average).
Ileum was affected in 21 (95%) patients, part of jejunum was simultaneously dilated in two cases; jejunum exclusively was affected in one case (5%). Resection of dilated segment with following primary anastomosis or creating a stoma was performed in all 21 (95%) operated patiens.
Defect of intestinal muscle layer in dilated segment was found in 11 (50%) patients. Prognosis was influenced mostly by general medical condition and prematurity associated diseases.
Conclusions: SDI is probably heterogeneous nosologic unit including more similar conditions of different origin. We presume possible diagnoses overlapping between SDI and segmental defect/absence of the intestinal musculature.