European J Pediatr Surg Rep. 2015; 03(02): 074-077
DOI: 10.1055/s-0035-1558460
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Thrombolysis for Severe Intestinal Ischemia due to Midgut Volvulus in a Neonate

Nouredin Messaoudi
1   Department of General, Digestive and Pediatric Surgery, Sint-Augustinus Hospital, Wilrijk, Belgium
,
Koen Vanlede
2   Department of Pediatrics, Sint-Augustinus Hospital, Wilrijk, Belgium
,
Dirk Vervloessem
3   Department of Pediatric Surgery, ZNA Queen Paola Children's Hospital, Antwerp, Belgium
,
Marc Huyghe
1   Department of General, Digestive and Pediatric Surgery, Sint-Augustinus Hospital, Wilrijk, Belgium
,
Paul Leyman
1   Department of General, Digestive and Pediatric Surgery, Sint-Augustinus Hospital, Wilrijk, Belgium
› Author Affiliations
Further Information

Publication History

18 March 2015

03 June 2015

Publication Date:
17 August 2015 (online)

Abstract

Intestinal malrotation complicated by the development of midgut volvulus presents a difficult management dilemma because of the risk of short bowel syndrome. Here, we present our experience with a case of severe intestinal ischemia after derotation in a newborn successfully managed using systemic tissue plasminogen activator. The present report supports the usefulness of thrombolysis as a therapeutic option for reperfusion of ischemic small bowel due to midgut volvulus in neonates.

 
  • References

  • 1 Goulet O, Ruemmele F. Causes and management of intestinal failure in children. Gastroenterology 2006; 130 (2) (Suppl. 01) S16-S28
  • 2 Buchman AL. Etiology and initial management of short bowel syndrome. Gastroenterology 2006; 130 (2) (Suppl. 01) S5-S15
  • 3 Kiely EM, Pierro A, Pierce C, Cross K, De Coppi P. Clot dissolution: a novel treatment of midgut volvulus. Pediatrics 2012; 129 (6) e1601-e1604
  • 4 Burke MS, Glick PL. Gastrointestinal malrotation with volvulus in an adult. Am J Surg 2008; 195 (4) 501-503
  • 5 Ade-Ajayi N, Hall NJ, Liesner R , et al. Acute neonatal arterial occlusion: is thrombolysis safe and effective?. J Pediatr Surg 2008; 43 (10) 1827-1832
  • 6 Janjua N, Nasar A, Lynch JK, Qureshi AI. Thrombolysis for ischemic stroke in children: data from the nationwide inpatient sample. Stroke 2007; 38 (6) 1850-1854
  • 7 Farnoux C, Camard O, Pinquier D , et al. Recombinant tissue-type plasminogen activator therapy of thrombosis in 16 neonates. J Pediatr 1998; 133 (1) 137-140
  • 8 Nowak-Göttl U, Schwabe D, Schneider W, Schlösser R, Kreuz W. Thrombolysis with recombinant tissue-type plasminogen activator in renal venous thrombosis in infancy. Lancet 1992; 340 (8827) 1105
  • 9 Levy M, Benson LN, Burrows PE , et al. Tissue plasminogen activator for the treatment of thromboembolism in infants and children. J Pediatr 1991; 118 (3) 467-472
  • 10 Zenz W, Arlt F, Sodia S, Berghold A. Intracerebral hemorrhage during fibrinolytic therapy in children: a review of the literature of the last thirty years. Semin Thromb Hemost 1997; 23 (3) 321-332
  • 11 Rimensberger PC, Humbert JR, Beghetti M. Management of preterm infants with intracardiac thrombi: use of thrombolytic agents. Paediatr Drugs 2001; 3 (12) 883-898
  • 12 Nomura F, Penny DJ, Menahem S, Pawade A, Karl TR. Surgical intervention for infective endocarditis in infancy and childhood. Ann Thorac Surg 1995; 60 (1) 90-95
  • 13 Nowak-Göttl U, Auberger K, Halimeh S , et al. Thrombolysis in newborns and infants. Thromb Haemost 1999; 82 (Suppl. 01) 112-116
  • 14 Manco-Johnson MJ, Grabowski EF, Hellgreen M , et al. Recommendations for tPA thrombolysis in children. On behalf of the Scientific Subcommittee on Perinatal and Pediatric Thrombosis of the Scientific and Standardization Committee of the International Society of Thrombosis and Haemostasis. Thromb Haemost 2002; 88 (1) 157-158