Internal hernia as cause of acute abdomen in a preterm neonate: when necrotizing enterocolitis is not the culprit
Abstract
Internal hernias in preterm neonates, although rare, can arise due to various anatomical and physiological factors associated with prematurity. We report a case of a preterm infant with symptoms of suspected necrotizing enterocolitis (NEC) that turned out to be an internal hernia during surgical exploration. Given the overlapping symptoms, it is crucial to maintain a high index of suspicion and utilize the appropriate imaging techniques, such as ultrasound or radiographic studies, to aid in the differentiation between NEC and internal hernia, especially when responding to cases that do not improve with standard NEC management or exhibit atypical features. Early recognition and accurate differentiation are crucial for appropriate management and prevention of complications in affected neonates.
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Internal hernia, Necrotizing enterocolitis, Preterm infant, Acute abdomen, Bowel ischemia
2. Willems E, Willaert B, Van Slycke S. Transmesenteric hernia: a rare case of acute abdominal pain in children: a case report and review of the literature. Acta Chir Belg. 2018;118(6):388-391. doi:10.1080/00015458.2017.1399662
3. Hirata K, Kawahara H, Shiono N, et al. Mesenteric hernia causing bowel obstruction in very low-birthweight infants. Pediatr Int. 2015;57(1):161-163. doi:10.1111/ped.12409
4. Kylat RI. Internal Hernia Masquerading As Necrotizing Enterocolitis. Front Pediatr. 2017;5:225. Published 2017 Oct 31. doi:10.3389/fped.2017.00225
5. Batsis ID, Okito O, Meltzer JA, Cunningham SJ. Internal Hernia as a Cause for Intestinal Obstruction in a Newborn. J Emerg Med. 2015;49(3):277-280. doi:10.1016/j.jemermed.2015.04.030
6. Newsom BD, Kukora JS. Congenital and acquired internal hernias: unusual causes of small bowel obstruction. Am J Surg. 1986;152(3):279-285. doi:10.1016/0002-9610(86)90258-8
7. Tang V, Daneman A, Navarro OM, Miller SF, Gerstle JT. Internal hernias in children: spectrum of clinical and imaging findings. Pediatr Radiol. 2011;41(12):1559-1568. doi:10.1007/s00247-011-2158-4
8. Zani A, Eaton S, Puri P, et al. International survey on the management of necrotizing enterocolitis. Eur J Pediatr Surg. 2015;25(1):27-33. doi:10.1055/s-0034-1387942
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