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Intestinal Obstruction II: Pathophysiology01:07

Intestinal Obstruction II: Pathophysiology

Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
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Extrahepatic Bile Duct and Gall Bladder Dissection in Nine-Day-Old Mouse Neonates
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Neonatal prolapsed patent vitellointestinal duct.

Ramnik V Patel1, Hemant Kumar, C K Sinha

  • 1Department of Paediatric Urology, University College London Hospitals NHS Foundation Trust, London, UK. ramnik@doctors.org.uk

BMJ Case Reports
|July 13, 2013
PubMed
Summary

A rare case of prolapsed patent vitellointestinal duct (PVID) in a neonate presented with obstruction symptoms. Surgical repair via transumbilical exploration yielded excellent results.

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Area of Science:

  • Pediatric Surgery
  • Neonatal Medicine
  • Gastrointestinal Anomalies

Background:

  • Patent vitellointestinal duct (PVID) is a rare congenital anomaly resulting from the incomplete obliteration of the omphalomesenteric duct.
  • PVID can lead to various complications, including intestinal obstruction, intussusception, and umbilical abnormalities.
  • Early diagnosis and surgical intervention are crucial for favorable outcomes in neonates with PVID.

Observation:

  • A 10-day-old neonate presented with vomiting, poor weight gain, and signs of partial intestinal obstruction.
  • A distinctive flower-like pink lesion prolapsed from the umbilicus.
  • A contrast study confirmed the lesion as a prolapsed patent vitellointestinal duct (PVID).

Findings:

  • The neonate underwent successful transumbilical exploration, resection, and anastomosis for the PVID.
  • This surgical approach provided both excellent cosmetic and functional results.
  • Flush umbilical cord clamping may be a contributing factor in converting Meckel's diverticulum to PVID.

Implications:

  • This case highlights the importance of recognizing PVID as a rare but significant cause of neonatal intestinal obstruction.
  • Transumbilical exploration is presented as an effective and minimally invasive surgical option for PVID.
  • Further investigation into the potential link between umbilical cord management and PVID development is warranted.