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Nebashi H, Inoue M, Ashizuka S, Samura O. Congenital segmental dilatation of the intestine in a neonate. BMJ Case Rep 2023; 16:e256842. [PMID: 38154863 PMCID: PMC10759025 DOI: 10.1136/bcr-2023-256842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023] Open
Abstract
A woman in her 30s at 29 weeks of gestation was diagnosed with a fetal abdominal cyst and polyhydramnios. As the cyst gradually increased in size, an elective caesarean section was performed at 38 weeks of gestation. The neonate experienced respiratory distress due to tense abdominal distension shortly after birth. An emergency laparotomy was performed. The intestinal tract was markedly dilated and contiguous with the cyst. The small bowel distal to the dilated intestine had herniated through the defect. The dilated segment was resected, and an ileostomy was created. The operative and histopathological findings suggested segmental dilatation of the intestine (SDI). SDI is a rare gastrointestinal disorder presenting during the neonatal period. It can cause respiratory failure in newborns by compression owing to its large size. SDI should be considered in the differential diagnosis of relatively large abdominal cysts, and collaboration with paediatric surgeons and neonatologists is necessary for successful outcomes.
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Affiliation(s)
- Hikari Nebashi
- Obstetrics and Gynecology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Momoko Inoue
- Obstetrics and Gynecology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Syuuichi Ashizuka
- Pediatric Surgery, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Osamu Samura
- Obstetrics and Gynecology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
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2
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Zeng FTA, Makaba SM, Hager J, Sergi CM. Congenital segmental dilatation of the intestine: an in-depth review. J Matern Fetal Neonatal Med 2023; 36:2259047. [PMID: 37726217 DOI: 10.1080/14767058.2023.2259047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/03/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE Congenital segmental dilatation of the intestine (CSDI) is a rare gastrointestinal condition. We conducted a scoping review through MEDLINE and Google Scholar, collecting data from 1959 through August 2020 to better understand this peculiar disease. METHODS The clinical and pathological features of 150 patients were reviewed. RESULTS The mean age was 25.9 days, and 61.3% of patients were male. An antenatal diagnosis was made in 15.3% of patients. Predominant symptoms included abdominal distension (83.9%) and vomiting (61.3%). Pallor and anemia were associated with ileal CSDI. The most common sites of the lesion were the ileum (56%) and colon (27.3%). Associated anomalies occurred in 57.3% of the patients, of which the most common included other abnormalities of the digestive system (69.8%), abdominal wall (19.8%), and cardiovascular system (11.6%). Resection and anastomosis was performed in 83.3% of patients. Postoperative complications occurred in 10%. Normal ganglion cells were commonly found (97.3%), while muscle layer hypertrophy and atrophy were found in 14.7% and 13.3% of the patients, respectively. Abnormal interstitial cells of Cajal were identified in four patients. Death occurred in 12.7% of patients. Demise was significantly associated with the duodenal location of CSDI (Mantel-Cox test, p = 0.002). CONCLUSION CSDI remains poorly understood, and mortality is associated chiefly with its duodenal location. Further research is needed, and biorepositories should be promptly set up to study this disease in the future better.
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Affiliation(s)
- Florent T A Zeng
- Department of Surgery, Université de Lubumbashi, Lubumbashi, Democratic Republic of Congo
| | - Samuel M Makaba
- Service of Pediatrics, Centre Médical du Centre ville, Lubumbashi, Democratic Republic of Congo
| | - Josef Hager
- Department of Pediatric Surgery, Medical University of Innsbruck, Austria
| | - Consolato M Sergi
- Anatomic Pathology Division, Children's Hospital of Eastern Ontario (CHEO), University of Ottawa, ON, Canada
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3
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Yokokawa H, Yoshida M, Takazawa S, Kutsukake M, Omata K, Ogawa S, Fujishiro J. A case of Hirschsprung's disease with segmental dilatation of the colon. Surg Case Rep 2023; 9:25. [PMID: 36788160 PMCID: PMC9929002 DOI: 10.1186/s40792-023-01602-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Segmental dilatation of the colon (SDC) is a rare disease that is characterized by an abrupt segment of dilated colon between regions of normal-sized colon. We herein report a case of SDC associated with Hirschsprung's disease (HD). CASE PRESENTATION The patient developed abdominal distension soon after birth, and enema examination showed localized intestinal dilatation from the descending colon to the sigmoid colon with significant caliber changes on both the oral and anal sides of the dilated colon. The findings of the rectal mucosal biopsy were consistent with HD. We considered this case to be a combination of HD and SDC and performed laparoscopic-assisted Soave pull-through with resection of the dilated colon when the patient was 7 months old. Resected specimens showed steep caliber changes on the oral and anal sides of the dilated colon. In the pathological examination, no ganglion cells were found in the submucosa on the anal side of the dilated colon. Based on the above findings, we finally made the diagnosis of HD with SDC. CONCLUSION In HD with a characteristic dilated colon, the possibility of SDC should be considered.
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Affiliation(s)
- Hideyuki Yokokawa
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
| | - Mariko Yoshida
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
| | - Shinya Takazawa
- grid.412708.80000 0004 1764 7572Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
| | - Mai Kutsukake
- grid.412708.80000 0004 1764 7572Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
| | - Kanako Omata
- grid.412708.80000 0004 1764 7572Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
| | - Shoko Ogawa
- grid.412708.80000 0004 1764 7572Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
| | - Jun Fujishiro
- grid.412708.80000 0004 1764 7572Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
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Okur Ö, Ergin M, Oral A, Hosgor M. Segmental Dilatation of Ileum Involving Bronchogenic Cyst in a Newborn. Fetal Pediatr Pathol 2023; 42:137-143. [PMID: 35438035 DOI: 10.1080/15513815.2022.2064573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Objective: Congenital segmental intestinal dilatation (SID) and bronchogenic cyst in the abdomen are two uncommon and different pathologies. We report a bronchogenic cyst associated with segmental intestinal dilatation. Case: A 2-day-old 3300 g term infant developed bilious vomiting. A jejunoileal segment with a diameter of 10 cm was detected at surgery. Histologically, the wall musculature and enteric plexus of the segmentally enlarged small intestine stained normally for CD117 and negative for calretinin. A bronchogenic cyst of 3 cm in diameter was centered on the mesenteric border of the dilated intestine. Conclusion: SID has a normal staining pattern for CD117 (for interstitial cells of Cajal) and negative for calretinin. it would suggest that the innervation is defective, may be associated with a bronchogenic cyst in the newborn, causing obstruction, requiring surgery.
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Affiliation(s)
- Özkan Okur
- Pediatric Surgery Department, University of Health Sciences Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Malik Ergin
- Pathology Department, University of Health Sciences Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Akgun Oral
- Pediatric Surgery Department, University of Health Sciences Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Munevver Hosgor
- Pediatric Surgery Department, University of Health Sciences Dr. Behcet Uz Children's Hospital, Izmir, Turkey
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Nugud AA, ELkholy NM, Omar AA, Qazi A, Tzivinikos C, Chencheri N, Khan S, Ba'Ath ME. Case Report: Expanding the Phenotypic Spectrum of Timothy Syndrome Type 1: A Sporadic Case With a de novo CACNA1C Pathogenic Variant and Segmental Ileal Dilatation. Front Pediatr 2021; 9:634655. [PMID: 33987151 PMCID: PMC8110704 DOI: 10.3389/fped.2021.634655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 04/06/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Long QT syndactyly syndrome (long QT syndrome type 8), also known as Timothy Syndrome (TS) was first described in 1994 with still <50 case reported in the literature. The full spectrum of the syndrome is not yet known. Results: Here we report a girl who presented with new onset refractory seizures and an undiagnosed cause of intermittent abdominal distention. She also had syndactyly of her fingers and toes and was found to have prolonged QT. Upon further investigations she was found to have a de novo pathogenic variant in CACNA1C, along with Segmental Ileal Dilatation (SID), and subsequently diagnosed with Timothy syndrome. Conclusion: To our knowledge, the association of Timothy Syndrome with Segmental Ileal Dilatation, was not described before.
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Affiliation(s)
- Ahmed A Nugud
- Al Jalila Children's Speciality Hospital, Dubai, United Arab Emirates
| | | | - Awad Alkarim Omar
- Al Jalila Children's Speciality Hospital, Dubai, United Arab Emirates
| | - Abid Qazi
- Al Jalila Children's Speciality Hospital, Dubai, United Arab Emirates
| | - Christos Tzivinikos
- Al Jalila Children's Speciality Hospital, Dubai, United Arab Emirates.,Department of Clinical Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | - Sabina Khan
- Al Jalila Children's Speciality Hospital, Dubai, United Arab Emirates
| | - Muhammad Eyad Ba'Ath
- Al Jalila Children's Speciality Hospital, Dubai, United Arab Emirates.,Department of Clinical Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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6
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Nakagawa Y, Harada T, Kaneoka Y. Congenital segmental dilatation of the intestine in extremely low birth weight infants. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2020.101506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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7
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Sergi C, Hager T, Hager J. Congenital Segmental Intestinal Dilatation: A 25-Year Review with Long-Term Follow-up at the Medical University of Innsbruck, Austria. AJP Rep 2019; 9:e218-e225. [PMID: 31304051 PMCID: PMC6624109 DOI: 10.1055/s-0039-1693164] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 04/26/2019] [Indexed: 12/24/2022] Open
Abstract
Background and Aim Congenital segmental intestinal dilatation (CSID) is a neonatal condition with unclear etiology and pathogenesis. Typically, the newborn with CSID presents with a limited (circumscribed) bowel dilatation, an abrupt transition between normal and dilated segments, neither intrinsic nor extrinsic perilesional obstruction, and no aganglionosis or neuronal intestinal dysplasia. We aimed to review this disease and the long-term follow-up at the Children's Hospital of the Medical University of Innsbruck, Tyrol, Austria. Study Design Retrospective 25-year review of medical charts, electronic files, and histopathology of neonates with CSID. Results We identified four infants (three girls and one boy) with CSID. The affected areas included duodenum, ileum, ascending colon, and sigmoid colon. Noteworthy, all patients presented with a cardiovascular defect, of which two required multiple cardiac surgical interventions. Three out of the four patients recovered completely. To date, the three infants are alive. Conclusion This is the first report of patients with CSID and cardiovascular defects. The clinical and surgical intervention for CSID also requires a thorough cardiologic evaluation in these patients. CSID remains an enigmatic entity pointing to the need for joint forces in identifying common loci for genetic investigations.
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Affiliation(s)
- Consolato Sergi
- Department of Orthopedics, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, Hubei, P.R. China.,Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.,Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Thomas Hager
- Institute of Pathology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany.,Institute of Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Josef Hager
- Department of Pediatric Surgery, Medical University of Innsbruck, Innsbruck, Austria
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8
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Uga N, Suzuki T, Sakurai K, Tsukamoto T, Tsuchiya T, Kondo Y, Naoe A, Watanabe S, Yasui T, Hara F. Segmental dilatation of colon detected on prenatal ultrasound. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2019. [DOI: 10.1016/j.epsc.2019.101208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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9
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Lindoso L, Ballengee CR, Patel KP, Romero R, Caltharp S, Alazraki AL, Kugathasan S. Multilocus Heterotopic Gastric Mucosa of Ileum Masquerading as VEOIBD in a Newborn. Pediatrics 2019; 143:peds.2018-2398. [PMID: 30898843 DOI: 10.1542/peds.2018-2398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2019] [Indexed: 11/24/2022] Open
Abstract
Heterotopic gastric mucosa (HGM) is defined as the presence of gastric mucosa outside of the stomach, which is documented by histologic finding. HGM is typically a solitary lesion; however, in our Case Report, the patient presented with multilocus HGM, an uncommon form in which the small bowel is extensively involved. We report a unique case of multilocus HGM mimicking very early-onset inflammatory bowel disease with recurrent gastrointestinal bleeding, chronic inflammation, and stricturing in a newborn patient. Histologic findings from the ileocecal specimen revealed multiple ulcers surrounded by chronic inflammation. Subsequently, a Technetium-99m pertechnetate scan demonstrated an increased tracer uptake in the remaining ileum. This radiologic finding, in combination with the discovery of gastric mucosa within the remainder of resected ileal specimen, led to the diagnosis of HGM. Omeprazole was initiated, and the patient is now asymptomatic without further gastrointestinal bleeding. Increased awareness of this rare disease and performing a Technetium-99m pertechnetate early can correctly diagnose HGM and prevent disease complication.
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Affiliation(s)
| | | | - Kiran P Patel
- Allergy and Immunology, Departments of Pediatrics.,Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Rene Romero
- Divisions of Gastroenterology and.,Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Shelley Caltharp
- Children's Healthcare of Atlanta, Atlanta, Georgia.,Pathology and Laboratory Medicine, and
| | - Adina L Alazraki
- Children's Healthcare of Atlanta, Atlanta, Georgia.,Radiology and Imaging Science, School of Medicine, Emory University, Atlanta, Georgia; and
| | - Subra Kugathasan
- Divisions of Gastroenterology and .,Children's Healthcare of Atlanta, Atlanta, Georgia
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10
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Abstract
Segmental dilatation of the intestine is a rare disease and mostly involves the ileal segment. It commonly presents in the neonatal period and early infancy with symptoms of partial or total obstruction. We report a rare case of an isolated jejunal segmental dilatation in a 7-year-old girl. The child presented with malnutrition and signs of subacute obstruction. The diagnosis was confirmed intraoperatively, and the dilated segment was resected. Although the etiology remains unknown, we discuss its clinical aspects and relevant literature.
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Affiliation(s)
- Amar A Shah
- Neonatal and Pediatric Surgeon, Amardeep Multispeciality Children Hospital and Research Center, Ahmedabad, Gujarat, India
| | - Anirudh V Shah
- Neonatal and Pediatric Surgeon, Amardeep Multispeciality Children Hospital and Research Center, Ahmedabad, Gujarat, India
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11
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Jain A, Cosgrove M, Aronson D. Segmental dilatation of small bowel presenting with severe anaemia: a diagnostic puzzle. BMJ Case Rep 2018; 2018:bcr-2017-222984. [PMID: 29378739 DOI: 10.1136/bcr-2017-222984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 7-year-old boy presented to Paediatric outpatient with worsening lethargy and tiredness. On examination he had extreme pallor. Blood investigations confirmed severe iron deficiency anaemia. He was started on iron supplements and received blood transfusion. However, the response to iron treatment was suboptimal, he therefore underwent extensive workup for the cause of iron deficiency anaemia. The barium meal showed dilated segments of ileum with two distal stenoses. The surgical resection of the involved segment was performed with end to end anastamosis. Histology of the resected segment was inconclusive of inflammatory bowel disease, malignancy or vascular malformation. The child has remained well since surgery with no further blood transfusion or iron therapy.
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Affiliation(s)
- Ankita Jain
- Department of Paediatrics, Abertawe Bro Morgannwg University Health Board, Swansea, UK
| | - Mike Cosgrove
- Department of Paediatrics, Morriston Hospital, Swansea, UK
| | - Daniel Aronson
- Department of Paediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
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12
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Johnson L, Simone K, Cullen J, Talley A, Cohen EB. Radiographic features of congenital segmental dilation of the intestine in a german shepherd dog. Vet Radiol Ultrasound 2017; 60:E62-E65. [PMID: 29205622 DOI: 10.1111/vru.12581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 09/08/2017] [Accepted: 09/08/2017] [Indexed: 11/28/2022] Open
Abstract
A 10-week-old spayed female German Shepherd Dog was presented for acute vomiting and diarrhea. There was no reported foreign body or toxin ingestion. Radiographs showed a severely (∼11 × 7 cm), focally distended right abdominal intestinal segment containing gas and soft tissue material. Other small intestinal segments were segmentally gas distended. Celiotomy identified a ∼9 cm focally dilated segment at the jejunoileal junction with no aborad luminal obstruction. Resection and anastomosis of the dilation was performed. Histopathology showed mild mucosal inflammation, but otherwise normal wall layering and autonomic ganglia. Radiographic and histopathologic findings were consistent with congenital segmental dilation of the intestine.
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Affiliation(s)
- Laura Johnson
- North Carolina State University College of Veterinary Medicine, Raleigh, NC, 27607
| | - Kristina Simone
- Molecular Biomedical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, 27606
| | - John Cullen
- Department of Population Health and Pathobiology, North Carolina State University College of Veterinary Medicine, Raleigh, NC, 27607
| | - Ashley Talley
- Molecular Biomedical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, 27606.,Department of Population Health and Pathobiology, North Carolina State University College of Veterinary Medicine, Raleigh, NC, 27607
| | - Eli B Cohen
- Molecular Biomedical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, 27606
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Segmental intestinal dilatation associated with omphalocele. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2017. [DOI: 10.1016/j.epsc.2017.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sakaguchi T, Hamada Y, Masumoto K, Taguchi T. Segmental dilatation of the intestine: results of a nationwide survey in Japan. Pediatr Surg Int 2015; 31:1073-6. [PMID: 26342490 DOI: 10.1007/s00383-015-3788-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE To clarify the status of segmental dilatation of the intestine (SD) using a nationwide retrospective cohort survey. METHODS Supported by the Ministry of Health, Labour and Welfare in Japan, preliminary questionnaires requesting the numbers of SD cases from 2000 to 2009 were sent to 161 Japanese major institutes of pediatric surgery and gastroenterology. We present the results of our analysis of the data from secondary questionnaires. RESULTS Twenty-eight cases of SD were reported, including 19 males and 9 females. The average gestational age was 30.2 weeks and the average birth weight was 2.319 g. The period of onset was neonatal in 18 cases and infancy in 6 cases, including 7 cases diagnosed prenatally. The dilated segment was ileum in 14 cases and colon in 10 cases, and symptoms included abdominal distention, vomiting, and chronic constipation. Concurrent intestinal malformation such as malrotation, intestinal atresia, and anal atresia were present in 4 cases and 27 of 28 cases were successfully treated by surgical resection. Histologically, abnormal muscle layers were found in three cases and ectopic tissue in two cases. CONCLUSION We determined the clinical features of SD based on data from 28 cases occurring over 10 years.
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Affiliation(s)
- Tatsuma Sakaguchi
- Department of Surgery, Kansai Medical University, 2-5-1 Shimmachi, Hirakata, Osaka, Japan.
| | - Yoshinori Hamada
- Department of Surgery, Kansai Medical University, 2-5-1 Shimmachi, Hirakata, Osaka, Japan
| | - Kouji Masumoto
- Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Tomoaki Taguchi
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, Japan
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A rare clinical presentation of heterotopic gastric mucosa of the jejunum: A case report and review of the literature. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2014. [DOI: 10.1016/j.epsc.2014.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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16
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Pathology survey on a captive-bred colony of the Mexican Goodeid, nearly extinct in the wild, Zoogoneticus tequila (Webb & Miller 1998). ScientificWorldJournal 2013; 2013:401468. [PMID: 24288481 PMCID: PMC3833030 DOI: 10.1155/2013/401468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 09/18/2013] [Indexed: 01/29/2023] Open
Abstract
The Mexican Goodeid, Zoogoneticus tequila, is considered nearly extinct in the wild and it is maintained in captivity by the nonprofit international “Goodeid Working Group.” The unique Italian colony has produced about 180 fish so far. The observable diseases were registered and some fish were submitted, immediately after spontaneous death, to necroscopic and histopathologic exams. Encountered diseases included the following: 7 cases of scoliosis (2 males and 5 females); 2 fish with a similar congenital deviation of ocular axis; 1 adult male with left corneal opacity, presumably of traumatic origin; 1 female fish with a large subocular fluid-filled sac, histologically referable to a lymphatic cyst, similarly to the eye sacs of a Goldfish variety (Carassius auratus) called bubble eye; and 1 female fish with recurrent abdominal distension consequent to distal bowel dilation and thinning, associated with complete mucosal atrophy, and comparable to intestinal pseudo-obstruction syndromes described in humans and various animal species. The absence of infectious or parasitic diseases, as well as the low incidence of diseases potentially related to environmental alterations or nutritional disorders such as spinal deformities, suggests the adequacy of breeding management techniques of Z. tequila for its conservation and reintroduction in to the original habitat in the near future.
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Paradiso FV, Coletta R, Olivieri C, Briganti V, Oriolo L, Fabbri R, Calisti A. Antenatal ultrasonographic features associated with segmental small bowel dilatation: an unusual neonatal condition mimicking congenital small bowel obstruction. Pediatr Neonatol 2013; 54:339-43. [PMID: 23597515 DOI: 10.1016/j.pedneo.2012.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 09/29/2011] [Accepted: 05/04/2012] [Indexed: 11/17/2022] Open
Abstract
Segmental dilatation of the intestine (SDI) is an unusual condition presenting during the neonatal period, with symptoms of obstruction. Late diagnosed cases are also reported. The clinical polymorphism, and the lack of specificity of radiological investigations, make diagnosis difficult. Prenatal detection of abdominal cystic lesions or bowel dilatation has occasionally been reported to be associated with SDI. We herein report two cases of SDI, with a prenatal ultrasonographic suspicion of intestinal abnormality. In both infants, a dilatation of the ileum was found at surgery, without any evident site of obstruction or abnormal histology. SDI must be taken into consideration when a prenatal alert of possible bowel obstruction is not followed by postnatal clinical signs.
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Lawther S, Patel RV, de la Hunt M. Ileal duplication cyst associated with segmental ileal stenosis and neonatal perforation. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2013. [DOI: 10.1016/j.epsc.2013.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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19
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Chung WD, Lim GY, Kim SY, Chung JH, Kim SJ. Haddad syndrome presenting with abdominal distension associated with long-segment aganglionosis. Clin Imaging 2012; 36:149-52. [PMID: 22370137 DOI: 10.1016/j.clinimag.2011.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 08/25/2011] [Indexed: 11/26/2022]
Abstract
Haddad syndrome is a form of neurocristopathy characterized by a combination of congenital central hypoventilation syndrome and Hirschsprung disease (HD). Although Haddad syndrome is extremely rare, awareness of the combination of long-segment HD in Haddad syndrome as well as radiographic manifestations may help to ensure a timely diagnosis as well as to facilitate optimal treatment of this unusual condition. We report a case of Haddad syndrome with long-segment, intestinal aganglionosis in a newborn infant. This report emphasizes the features of HD in children with Haddad syndrome and suggests that specific attention be given to its interpretation on plain radiographs.
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Affiliation(s)
- Woong Do Chung
- Department of Radiology, St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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21
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Congenital segmental dilatation of the duodenum: report of a case. Surg Today 2011; 41:406-8. [PMID: 21365425 DOI: 10.1007/s00595-010-4257-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Accepted: 01/19/2010] [Indexed: 10/18/2022]
Abstract
We herein report what, to our knowledge, is only the fourth known case of segmental dilatation of the duodenum. Antenatal ultrasonography revealed an intraabdominal cyst in the fetus, but the exact location of the segmental dilatation was difficult to find preoperatively. Moreover, even using computed tomography, it was not possible to make a diagnosis prior to surgery. The anatomic characteristics of duodenal dilatation made it difficult to perform the usual resection techniques. In fact, the surgical procedure was different from the previously reported cases. We performed a partial resection of the duodenum followed by a tapering procedure to preserve the ampulla of Vater. The infant had an uneventful postoperative course, and sufficient growth and development has been achieved.
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Inoue M, Uchida K, Otake K, Koike Y, Miki C, Kusunoki M. Congenital segmental dilatation of the duodenum: report of a case. Pediatr Int 2010; 52:e184-6. [PMID: 20958859 DOI: 10.1111/j.1442-200x.2010.03117.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Mikihiro Inoue
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
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Disorders of interstitial cells of Cajal in a neonate with segmental dilatation of the intestine. J Pediatr Surg 2010; 45:e11-4. [PMID: 20620293 DOI: 10.1016/j.jpedsurg.2010.03.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 03/21/2010] [Accepted: 03/22/2010] [Indexed: 11/23/2022]
Abstract
Localized myopathy of the muscular layers may be an important factor contributing to segmental dilatation of the intestine (SDI). Only one report has described SDI of the jejunum in a neonate showing no abnormality of the interstitial cells of Cajal (ICC). The present report describes the very rare case of a neonatal girl with segmental dilatation of the distal duodenum and proximal jejunum with irregular arrangements of Auerbach's plexus and ICC and the successful surgical treatment of SDI. We review the literature on this type of relationship between abnormality of ICC and SDI and discuss the clinical features of this complication. Furthermore, the possible neuropathic cause of SDI complicated with disorders of ICC was explored in this report.
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Park JS, Doh HJ, Park ES, Seo JH, Lim JY, Park CH, Woo HO, Youn HS. Segmental dilatation of the ileum presenting as a cystic lesion on prenatal ultrasonography in one twin. Pediatr Int 2010; 52:337-8. [PMID: 20500491 DOI: 10.1111/j.1442-200x.2010.03070.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Segmental ileal obstruction in neonates--a rare entity. J Pediatr Surg 2009; 44:1827-30. [PMID: 19735834 DOI: 10.1016/j.jpedsurg.2009.05.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Revised: 05/18/2009] [Accepted: 05/23/2009] [Indexed: 11/23/2022]
Abstract
Congenital segmental dilatation of a portion of the small intestine in neonates causing intestinal obstruction is quite uncommon. We hereby report 2 such cases. In both infants, there was localized dilatation of the ileum with collapse of the distal bowel and functional intestinal obstruction without loss of continuity of the bowel wall or lack of ganglion cells.
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Brown BR, Hennessey I, Lansdale N, Humphrey G. Pancreatic tissue in congenital segmental dilatation of intestine: case presentation and recommendation for treatment. J Pediatr Surg 2008; 43:e9-e11. [PMID: 18970923 DOI: 10.1016/j.jpedsurg.2008.06.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2008] [Revised: 06/28/2008] [Accepted: 06/30/2008] [Indexed: 11/25/2022]
Abstract
Segmental dilatation of intestine (SDI) is a very uncommon condition affecting children. The case that we present suggests that SDI may have may histologic findings in common with vitellointestinal remnants. A limited resection or other minimal procedure to preserve bowel length is usually undertaken for SDI. However, this case illustrates that the dilated segments of small bowel should be completely excised, in the same fashion as for vitellointestinal duct remnants, because of the possible presence of ectopic gastric mucosa and exocrine pancreatic tissue.
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Affiliation(s)
- Bazil Ricardo Brown
- Department of Surgery, Royal Manchester Children's Hospital, Manchester, UK.
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Marven S, Owen A. Contemporary postnatal surgical management strategies for congenital abdominal wall defects. Semin Pediatr Surg 2008; 17:222-35. [PMID: 19019291 DOI: 10.1053/j.sempedsurg.2008.07.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Early definitive closure of abdominal wall defects is possible in most cases. Staged reduction does offer distinct advantages, and mortality and morbidity may be better. Risk stratification may produce outcome and tailor management of difficult cases in the form of a clinical pathway. Stem cell technology may, in the future, offer the ideal allogenic prosthesis in complex cases.
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Affiliation(s)
- Sean Marven
- Sheffield Children's Hospital NHS Foundation Trust, Western Bank, United Kingdom.
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Segmental dilatation of the ileum accompanying hypoproteinemia. J Pediatr Surg 2008; 43:e15-8. [PMID: 18639668 DOI: 10.1016/j.jpedsurg.2008.02.084] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2007] [Revised: 02/28/2008] [Accepted: 02/28/2008] [Indexed: 11/20/2022]
Abstract
PURPOSE Segmental intestinal dilatation (SID) is a rare pathologic finding, which causes intestinal obstruction in newborn period and gastrointestinal bleeding, anemia, abdominal pain, malabsorption, and growth failure in older children. We present a case of SID causing hypoproteinemia. PATIENT A 10-year-old girl presented with recurrent abdominal distension since she was 8.5 months old. She was diagnosed to have protein-losing intestinal lymphangiectasia. Result of physical examination was normal except moderate growth retardation. Her blood workup showed depletion in total protein, albumin, and globulin levels. Gastrointestinal series revealed a dilated segment of small intestine, and Tc(99m)-pertechnetate scintigraphy detected ectopic activity in abdomen. The patient was taken to operation with the presumptive diagnosis of intestinal duplication. A dilated segment of ileum was encountered, and segmental resection and anastomosis were performed. RESULTS Patient was discharged on the postoperative fourth day and remains well. Histopathologic examination of the specimen revealed SID. DISCUSSION Segmental intestinal dilatation is an uncommon congenital anomaly. Most of the cases were operated on in newborn period because of intestinal obstruction, and their diagnoses were made perioperatively; the others were diagnosed in older ages during the investigation of nonspecific symptoms. The index patient is the second case of SID having hypoproteinemia in the literature. Gastrointestinal series suggested the diagnosis, and segmental resection and anastomosis were the adequate treatments.
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Oberhelman AP, Herman TE, McAlister WH, Keating JP, Rollins MD, Dillon PA. CT manifestations of ileal dysgenesis. Pediatr Radiol 2007; 37:209-12. [PMID: 17115213 DOI: 10.1007/s00247-006-0351-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Revised: 09/26/2006] [Accepted: 10/09/2006] [Indexed: 10/23/2022]
Abstract
Ileal dysgenesis is an uncommon condition of unknown etiology occurring in the distal ileum in the region of the vitelline duct. The CT appearance of this lesion, although not previously described to our knowledge, is characteristic. We report a patient with ileal dysgenesis who had an abdominal CT scan to evaluate chronic iron deficiency anemia and protein-losing enteropathy. Recognition of this lesion by pediatric radiologists is important; so that surgical treatment, which is simple and effective, can be initiated quickly.
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Affiliation(s)
- Amy P Oberhelman
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Department of Radiology, St. Louis Children's Hospital, 510 South Kingshighway Blvd., St. Louis, MO 63110, USA
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