Segmental absence of intestinal musculature increasingly recognized in premature infants with perforated viscus: A case series
Introduction: Segmental absence of intestinal musculature (SAIM) is a pathological diagnosis, denoting focal absence of the muscularis propria in the presence of intact surrounding structures. This condition often presents as spontaneous intestinal perforation (SIP) and can be difficult to distingui...
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Elsevier
2024-12-01
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| Series: | Journal of Pediatric Surgery Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S221357662400143X |
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| author | Carolina Pinzon-Guzman Alexander Kevorkov Karl Grenier Maeve O'Neill Trudeau Pramod Puligandla Etienne St-Louis |
| author_facet | Carolina Pinzon-Guzman Alexander Kevorkov Karl Grenier Maeve O'Neill Trudeau Pramod Puligandla Etienne St-Louis |
| author_sort | Carolina Pinzon-Guzman |
| collection | DOAJ |
| description | Introduction: Segmental absence of intestinal musculature (SAIM) is a pathological diagnosis, denoting focal absence of the muscularis propria in the presence of intact surrounding structures. This condition often presents as spontaneous intestinal perforation (SIP) and can be difficult to distinguish clinically from necrotizing enterocolitis (NEC). Case presentations: We present 5 cases of premature babies with gestational age ranging from 24 + 3 weeks up to 32 + 1 weeks, who all presented with intestinal perforation before the 15th day of life. Three patients presented with a distended abdomen and discoloration and were subsequently found to have pneumoperitoneum on abdominal x-ray (AXR). The 2 other patients presented with clinical deterioration but without signs of intestinal perforation and were subsequently found to have pneumoperitoneum on AXR. All underwent bowel resection of perforated bowel with either ileostomy with mucous fistula or primary end-to-end anastomosis. Two patients required repeat exploratory laparotomies within a week of their initial surgery due to pneumoperitoneum in subsequent AXR caused by new perforations in other parts of the small bowel. One patient sustained an iatrogenic liver injury intra-operatively and passed away 1 day post-operatively. All patients were found to have SAIM on histopathological examination. Conclusion: SAIM is a pathological diagnosis that can manifest as SIP and may denote a risk for recurrent peritonitis in premature infants who underwent bowel resection for perforated viscus without a clear etiology. |
| format | Article |
| id | doaj-art-6b4a2e4a62364be3ad7b1b24f4f8f868 |
| institution | Kabale University |
| issn | 2213-5766 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Case Reports |
| spelling | doaj-art-6b4a2e4a62364be3ad7b1b24f4f8f8682024-11-11T04:25:30ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662024-12-01111102915Segmental absence of intestinal musculature increasingly recognized in premature infants with perforated viscus: A case seriesCarolina Pinzon-Guzman0Alexander Kevorkov1Karl Grenier2Maeve O'Neill Trudeau3Pramod Puligandla4Etienne St-Louis5McGill University Health Centre, Montreal Children's Hospital, Harvey E. Beardmore Division of Pediatric Surgery, Montreal, QC, CanadaMcGill University, Faculty of Medicine and Health Sciences, Montreal, QC, CanadaMcGill University Health Centre, Montreal Children's Hospital, Department of Pathology, Montreal, QC, CanadaMcGill University Health Centre, Montreal Children's Hospital, Harvey E. Beardmore Division of Pediatric Surgery, Montreal, QC, CanadaMcGill University Health Centre, Montreal Children's Hospital, Harvey E. Beardmore Division of Pediatric Surgery, Montreal, QC, CanadaMcGill University Health Centre, Montreal Children's Hospital, Harvey E. Beardmore Division of Pediatric Surgery, Montreal, QC, Canada; Corresponding author.Introduction: Segmental absence of intestinal musculature (SAIM) is a pathological diagnosis, denoting focal absence of the muscularis propria in the presence of intact surrounding structures. This condition often presents as spontaneous intestinal perforation (SIP) and can be difficult to distinguish clinically from necrotizing enterocolitis (NEC). Case presentations: We present 5 cases of premature babies with gestational age ranging from 24 + 3 weeks up to 32 + 1 weeks, who all presented with intestinal perforation before the 15th day of life. Three patients presented with a distended abdomen and discoloration and were subsequently found to have pneumoperitoneum on abdominal x-ray (AXR). The 2 other patients presented with clinical deterioration but without signs of intestinal perforation and were subsequently found to have pneumoperitoneum on AXR. All underwent bowel resection of perforated bowel with either ileostomy with mucous fistula or primary end-to-end anastomosis. Two patients required repeat exploratory laparotomies within a week of their initial surgery due to pneumoperitoneum in subsequent AXR caused by new perforations in other parts of the small bowel. One patient sustained an iatrogenic liver injury intra-operatively and passed away 1 day post-operatively. All patients were found to have SAIM on histopathological examination. Conclusion: SAIM is a pathological diagnosis that can manifest as SIP and may denote a risk for recurrent peritonitis in premature infants who underwent bowel resection for perforated viscus without a clear etiology.http://www.sciencedirect.com/science/article/pii/S221357662400143XSegmental absence of intestinal musculatureIntestinal perforationPremature neonatesCase series |
| spellingShingle | Carolina Pinzon-Guzman Alexander Kevorkov Karl Grenier Maeve O'Neill Trudeau Pramod Puligandla Etienne St-Louis Segmental absence of intestinal musculature increasingly recognized in premature infants with perforated viscus: A case series Journal of Pediatric Surgery Case Reports Segmental absence of intestinal musculature Intestinal perforation Premature neonates Case series |
| title | Segmental absence of intestinal musculature increasingly recognized in premature infants with perforated viscus: A case series |
| title_full | Segmental absence of intestinal musculature increasingly recognized in premature infants with perforated viscus: A case series |
| title_fullStr | Segmental absence of intestinal musculature increasingly recognized in premature infants with perforated viscus: A case series |
| title_full_unstemmed | Segmental absence of intestinal musculature increasingly recognized in premature infants with perforated viscus: A case series |
| title_short | Segmental absence of intestinal musculature increasingly recognized in premature infants with perforated viscus: A case series |
| title_sort | segmental absence of intestinal musculature increasingly recognized in premature infants with perforated viscus a case series |
| topic | Segmental absence of intestinal musculature Intestinal perforation Premature neonates Case series |
| url | http://www.sciencedirect.com/science/article/pii/S221357662400143X |
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