A pitfall in the interpretation of plain abdnominal radiographs in neonatal intestinal perforation: a case reportReportar como inadecuado




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Journal of Medical Case Reports

, 2:335

First Online: 28 October 2008Received: 12 February 2008Accepted: 28 October 2008DOI: 10.1186-1752-1947-2-335

Cite this article as: Gillies, M.J., Chowdhury, M.M. & Lakhoo, K. J Med Case Reports 2008 2: 335. doi:10.1186-1752-1947-2-335

Abstract

IntroductionThe recognition of neonatal intestinal perforation relies on identification of free gas in the peritoneum on plain abdominal radiographs and the associated clinical signs. The neonatal bowel takes several hours to fill with gas, potentially obscuring one of the radiological signs of bowel perforation in the neonate.

Case presentationWe describe the case of a male, Caucasian neonate, born prematurely at 35 weeks of gestation, who was suspected before birth to be at risk of intestinal perforation, based on antenatal ultrasound signs of bowel obstruction. However, the diagnosis of intestinal perforation after birth was initially delayed because the first abdominal radiograph, requested by the neonatal team, was taken too early in the clinical progression of the neonate-s condition. As a consequence, this delayed referral to the paediatric surgical team and definitive management.

ConclusionThis case illustrates how consideration of the timing of abdominal radiographs in suspected intestinal perforation in the neonate may avoid misinterpretation of radiographic signs, thereby avoiding delays in referral and treatment in the crucial first few hours of life.

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-2-335 contains supplementary material, which is available to authorized users.

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Autor: Martin J. Gillies - Moti M. Chowdhury - Kokila Lakhoo

Fuente: https://link.springer.com/



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