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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
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Delayed diagnosis in a child with strangulated mesenteric hernia
Kenichi Tetsuhara1, Kazunobu Nakabayashi2, Mamoru Muraoka1
1Department of Critical Care Medicine Fukuoka Children's Hospital Fukuoka Japan.
Acute Medicine & Surgery
|June 19, 2024
Summary
Strangulated intestinal obstruction in children can be a life-threatening emergency. Early diagnosis is crucial to prevent severe complications and improve outcomes in pediatric shock cases.
Area of Science:
- Pediatric Surgery
- Emergency Medicine
- Critical Care
Background:
- Strangulated intestinal obstruction is a critical diagnosis in pediatric shock.
- Diagnostic challenges can lead to delays and errors in management.
- Prompt recognition is vital for patient survival.
Observation:
- A 3-month-old infant presented with shock, lactic acidosis, and altered mental status.
- Clinical signs included abdominal distension and acute kidney injury requiring renal replacement therapy.
- Delayed diagnosis (33.5 hours) due to diagnostic pitfalls occurred.
Findings:
- Contrast-enhanced CT revealed extensive intestinal ischemia.
- The infant was diagnosed with strangulated mesenteric hernia.
- Four specific pitfalls contributed to the diagnostic delay.
Implications:
- Highlights the importance of considering strangulated intestinal obstruction in pediatric shock.
- Emphasizes the need to identify and address diagnostic errors in intensive care settings.
- Underscores the critical role of timely diagnosis and intervention in pediatric surgical emergencies.
