Neonatal Intestinal Obstruction

Posted by e-Medical PPT
Causes of Neonatal Intestinal Obstruction
Colon atresia
Meconium plug
Meconium ileus
Anorectal malformation
Small left colon syndrome
Megacystic-microcolon-intestinal hypoperstalsis syndrome

Colon atresia
Lest common one of the intestinal atresia , the common site is transverse colon
Ischemia in the vascularity of the mesentery necroses of the bowel segment
Polyhydraminos
Contrast enema is diagnostic obstruction site, and distal atrophy , proximal dilatation
Treatment resection of the dilated part and reanastomosis

Meconium plug
Mildest and the most common
Etiology is not clear
No fluid on x-ray
Contrast :diagnostic
Treatment :  rectal stimulation

Meconium ileus
30% of intestinal obstruction, usually present in the first days in life
50% associated with other intestinal problem (volvulus , atresia, perforation )
15% of patients with cystic fibrosis (AR)
P.R: small caliber of rectum, rectum is empty
X-ray: ground- glass appearance
Contrast enema: empty micro colon, entrapment of   meconium in the ileum
50% present with complication (meconium peritonitis, perforation)
X-ray: intraperitonial calcification, free air or very large air_ fluid levels
Treatment : gastrograffin enema administration
Operative evacuation of the obstruction by irrigation

Small left colon syndrome
Rare cause
History of maternal diabetes with abnormal glucose tolerance test in 50%
infants how are hypoglycemic
septic
an association with hypothyroidism, hypermagnesaemia
Ass/e  maternal use of psychotic medication
Dysmotility in the descending colon  


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