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Neonatal intestinal pseudoobstruction.

C E Bagwell, R M Filler, E Cutz

    Journal of Pediatric Surgery
    |December 1, 1984
    PubMed
    Summary
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    Neonatal intestinal pseudoobstruction, a rare condition, may resolve spontaneously in some infants, even those with megacystis. Long-term nutritional support and management of co-occurring anomalies are key therapeutic strategies.

    Area of Science:

    • Pediatric Gastroenterology
    • Neonatal Surgery

    Background:

    • Neonatal intestinal pseudoobstruction is a rare condition mimicking mechanical obstruction.
    • Diagnosis requires excluding sepsis, meconium ileus, Hirschsprung's disease, and mechanical causes.

    Observation:

    • Ten infants diagnosed with pseudoobstruction over 10 years, excluding mechanical causes.
    • Associated anomalies included gastroschisis, ileal atresia, and megacystis in some patients.
    • Radiocontrast studies revealed aperistalsis or segmentation; rectal manometry was unhelpful.

    Findings:

    • Histology showed normal nerves in seven, nerve deficiency in one, and myopathy in another.
    • Pharmacological treatments for peristalsis were ineffective.
    • Six survivors showed improved peristalsis, with three tolerating regular diets.

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    Implications:

    • Neonatal intestinal pseudoobstruction may be self-limiting in some cases, contrary to previous reports.
    • Long-term total parenteral nutrition (TPN) and intestinal decompression are crucial.
    • Management should address co-occurring anomalies and provide sustained nutritional support.