CASE OF MULTIPLE ACUTE SMALL BOWEL PERFORATIONS IN A CHILD AGED 9 MONTHS OLD

Abstract

The article presents the clinical observation of a child 9 months old with multiple perforations of the small intestine, which appeared against the background of acute enteritis of unknown etiology. Long-term surgical treatment was performed. At the first stage, a sanation laparotomy was performed with excision of jejuno- and ileostomy with the intubation of the small intestine. After the reversal phenomena of peritonitis, the closure of the jejunostomy with intubation of the small intestine was performed. The final stage was the closure of ileostomy. The total duration of the treatment is 2 months. A brief review of the literature devoted to multiple perforations of the small intestine in children with a description of the etiology, pathogenesis and treatment of this disease is given.

Keywords

children / perforation of the small intestine / ischemia of the intestinal wall

References

[1] Grosfeld J.L., Molinari F., Pharm D., Chaet M., Engum S.A., West K.W. et al. Gastrointestinal perforation and peritonitis in infants and children: Experience with 179 cases over ten years. Surgery. 1996; 120(4): 650-6.

[2] Adeniran J.O., Taiwo J.O., Abdur-Rahman L.O. Salmonella intestinal perforation: (27 perforations in one patient, 14 perforations in another) are the goal posts changing? J. Indian Assoc. Pediatr. 2005; 10(4): 248-51.

[3] Jeng-Chang Ch., Chiu-Chiang Ch., Jin-Tung L., Shiu-Feng H. Spontaneous bowel perforation in infants and young children: a clinicopathologic analysis of pathogenesis. J. Pediatric. Gastroenterology & Nutrition. 2000; 30(4): 432-5.

[4] Kim S.H., Cho Y.H., Kim H.Y. Spontaneous perforation of colon in previously healthy infants and children: its clinical implication. Pediatr. Gastroenterol. Hepatol. Nutr. 2016; 19(3):193-8.

[5] Chang Y.J., Yan D.C., Kong M.S., Chao H.C., Huang C.S., Lai J.Y. Non-traumatic colon perforation in children: a 10-year review. Pediat. Surg. Int. 2006; 22: 665-9.

[6] Султонов Ш.Р., Сафаров А.С. Комплексная диагностика и лечение брюшнотифозного перитонита в детском возрасте. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2013; 3(1): 40-3

[7] Loh A.H.P., Ong L.Y., Liew W.K., Arkachaisri T., Lee V.K.M., Narasimhan K.L. et al. Multiple indomethacin-induced colonic perforations in an adolescent. Singapore Med. J. 2011; 52(4): 82-4

[8] Жариков А.Н., Лубянский В.Г., Кантеева Ю.Л., Лядгина Т.В. Влияние нарушений региональной гемодинамики и микроциркуляции кишечной стенки на возникновение острых перфораций тонкой кишки. Вестник экспериментальной и клинической хирургии. 2015; 8(1): 34-44

[9] Bower T.C. Ischemic colitis. Surg. Clin. North. Am. 1993; 73: 1037-53.

[10] Huang S.F., Vacanti J., Kozakewich H. Segmental defect of the intestinal musculature of a newborn: Evidence of acquired pathogenesis. J. Pediatr. Surg. 1996; 31: 721-5.

[11] Meyer C.L., Payne N.R., Roback S.A. Spontaneous, isolated intestinal perforations in neonates with birth weight № 1.000 g not associated with necrotizing enterocolitis. J. Pediatr. Surg. 1991; 26: 714-7.

[12] Mitsudo S., Brandt L.J. Pathology of intestinal ischaemia. Surg. Clin. North. Am. 1992; 72: 43-63.

[13] Guttormson N.L., Bubrick M.P. Mortality from ischemic colitis. Dis. Colon. Rectum. 1989; 32: 469-72.

[14] Agca H., Bozkurt M.A. Pneumonia case caused by cedecea lapagei. J. Clin. Anal. Med. 2014; 5(2): 147-8.