Atresia y estenosis intestinal en paciente pediátrico

Abstract

The following investigation's work a case of a newborn with intestinal atresia type III b in apple peel and type IV with poor intestinal and short bowel rotation found in the Hospital General Docente de Riobamba, the importance of its study, lies in the information on the severity and prognosis of this congenital anomaly since in our country the information is scarce and the degree of mortality is high. Neonate a term of 39.6 weeks, cephalovaginal delivery, male sex, mestizo ethnic group, apgar 8/9, without any complication, product of 35-year-old mother, who did not have any prenatal check-up or ultrasound. Within the clinical picture, neonate presented episodes of vomiting after 24 hours of life, absence of bowel movements, abdominal distension, and gastric residue. With the clinical described plus the complementary examinations, it was proposed as a diagnostic impression, intestinal obstruction: yeyunal atresia vs Ileal atresia. Subsequent to this, an exploratory laparotomy was performed, revealing distal atresias in a number of 5.4 at the level of the ileum (type IV) and 1 at the level of the jejunum (type III). A resection of multiple atresias and terminal end anastomosis without monoplane proximal remodeling was performed, the prognosis was poor due to the degrees of atresia and the important shortening of the intestinal length, in addition to the complications presented during its hospital instance, such as late Sepsis of the newborn. It is important to educate the pregnant woman so that during her pregnancy she goes to the prenatal controls, since an early diagnosis or the suspicion of this, it would improve the prognosis of life by performing the immediate surgery. Studies of intestinal atresia in apple peel (III b) associated multiple atresias (IV), are very rare; these cases have higher morbidity and mortality rates.