Current management of short bowel syndrome in children.
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Intrauterine intussusception has been implicated as a potential cause of intestinal atresia but has not been associated previously with nonimmune hydrops fetalis. We report a patient with a significant family history of intussuception who had intrauterine intussusception associated with nonimmune hydrops fetalis.
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We describe three children with surgically confirmed meconium peritonitis. All had abnormal prenatal ultrasonographic examinations. The first child showed multiple cysts, the second had hydrops fetalis, and the third had dilated bowel loops. A polyhydramnion was common to all three cases. Of the two children who died, one had cystic fibrosis. It is remarkable that the ultrasonographic findings were different in the three children.
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Volvulus, ileus, and internal herniation may be consequences of intestinal malposition in childhood. Bacterial overgrowth, obstipation, diarrhoea, and malabsorption may additionally develop over time in the absence of adequate treatment. One in three positional abnormalities is diagnosed only intraoperatively. The surgeon has to expect such surprise findings as a condition for adequate therapeutic action.
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