Case of a fatal congenital transmesenteric hernia in infancy

IF 1.3 4区 医学 Q3 MEDICINE, LEGAL
Veljko Milošević, Tijana Petrović, Irina Banjanin, Bojana Radnić, Milenko Bogdanović
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Abstract

We present a case of transmesenteric hernia resulting in the death of a 3-month-old female infant, the seventh such autopsy case reported so far. A three-month-old female infant, who initially presented with two episodes of vomiting, cramps, and constipation, was admitted to the hospital. She received symptomatic therapy and was released home. Immediately after she had been put to bed at home, she stopped breathing. There was no record of previous illnesses in the infant’s medical history. At autopsy, a necrotic segment of ileum and jejunum, length about 50 cm, was found herniated through an oval defect in the mesentery and multiply strangulated. The shock caused by small intestinal obstruction with consequent intestinal necrosis due to strangulation of the small intestine through a congenital mesenteric defect was considered to be the cause of death. In clinical practice, cases of transmesenteric hernias are uncommon, especially in the population of infants and toddlers; however, these can potentially be the cause of serious intestinal obstruction, with a high mortality rate in cases left untreated. Despite the low incidence of this condition, we believe that the clinicians should keep this diagnosis in mind as a potential cause of acute abdomen and pay special attention to revealing the cause of presented symptoms.
一例致命的婴儿先天性跨肠管疝。
我们报告了一例导致一名 3 个月大女婴死亡的经肠管疝气病例,这是迄今为止报告的第七例此类尸检病例。一名三个月大的女婴最初因两次呕吐、痉挛和便秘而入院。她接受了对症治疗后出院回家。她在家中就寝后,立即停止了呼吸。在婴儿的病史中,没有以往患病的记录。尸检发现,一段长度约为 50 厘米的坏死回肠和空肠通过肠系膜上的椭圆形缺损疝出并多处绞窄。先天性肠系膜缺损导致的小肠梗阻引起的休克和随后的肠坏死被认为是死亡原因。在临床实践中,经肠系膜疝的病例并不常见,尤其是在婴幼儿群体中;然而,这些病例有可能导致严重的肠梗阻,如果不及时治疗,死亡率很高。尽管这种疾病的发病率很低,但我们认为临床医生应将其作为急腹症的潜在病因,并特别注意揭示引起症状的原因。
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来源期刊
Legal Medicine
Legal Medicine Nursing-Issues, Ethics and Legal Aspects
CiteScore
2.80
自引率
6.70%
发文量
119
审稿时长
7.9 weeks
期刊介绍: Legal Medicine provides an international forum for the publication of original articles, reviews and correspondence on subjects that cover practical and theoretical areas of interest relating to the wide range of legal medicine. Subjects covered include forensic pathology, toxicology, odontology, anthropology, criminalistics, immunochemistry, hemogenetics and forensic aspects of biological science with emphasis on DNA analysis and molecular biology. Submissions dealing with medicolegal problems such as malpractice, insurance, child abuse or ethics in medical practice are also acceptable.
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