[Surgery in atresia of the large intestine].
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Congenital laryngeal obstruction is a rare but serious cause of severe, often fatal, post partum asphyxia. The condition should be recognized and in most cases an artificial airway has to be established immediately because hypoxia allows little time for extensive evaluation. Thereafter a further diagnostic procedure by means of laryngobronchoscopy and contrast laryngography should be performed. The clinical picture of two cases with a congenital laryngeal stenosis is described and the initial therapeutic approach is discussed.
The human fetus swallows a considerable amount of amniotic fluid which appears to be in balance with the urine output. Since amniotic fluid intake is considered to be compromised in fetuses with atresia of the upper gastrointestinal tract, glomerular function development in such infants may be delayed. Plasma creatinine level determined in 6 neonates with atresia of the upper gastrointestinal tract was similar to the level measured in neonates with lower obstruction, and both groups were within the range of values obtained during other studies in normal newborns. Glomerular functional development is probably not affected in neonates with atresia of the upper gastrointestinal tract.
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This is a report of a unique case of biliary and rectal atresia.
A new variant of esophageal atresia (EA) with tracheoesophageal fistula (TEF) associated with duodenal atresia is reported. The TEF was between the lower pouch and the trachea, with a cystic dilatation in the midportion. The tracheal end of the fistula was obstructed by a membranous septum at both ends of a cystic dilatation, leading to a diagnosis of pure EA (gasless abdomen). After the lower pouch was opened beyond the cystic dilatation, 100 ml nonbilious fluid was obtained. A laparotomy revealed a type III atresia of the first part of the duodenum.
A woman was referred at 25 weeks' gestation with decreased fetal movements. Ultrasound revealed a large solid fetal abdominal mass and gross fetal ascites. Amniocentesis and viral titers were normal. On subsequent ultrasound examinations, the mass and ascites slowly disappeared, but a small bowel obstruction developed. Spontaneous labor occurred at 35 weeks and the child was born with a distended abdomen. At laparotomy there was type 3 jejunal atresia, indicating that the fetal mass and ascites were secondary to this antenatal small bowel ischemia.
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