CC BY 4.0 · European J Pediatr Surg Rep. 2021; 09(01): e17-e19
DOI: 10.1055/s-0040-1721406
Case Report

Loop Ileostomy in Europe's Tiniest Male Newborn for Meconium-Related Ileus

Holger Till
1  Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
,
Georg Singer
1  Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
,
Christoph Castellani
1  Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
,
Berndt Urlesberger
2  Department of Paediatrics and Adolescent Medicine, Division of Neonatology, Medical University of Graz, Graz, Austria
› Author Affiliations

Abstract

With the advances of neonatology, the survival rate for “live-born periviable fetuses” weighing < 300 g, a subgroup of extremely low birth weight (BW) infants, has improved over the past 10 years. Meconium-related ileus (MRI) represents an early postnatal hazard, and, if medical evacuation fails, a surgical challenge in such immature babies. We report the interdisciplinary management of surgically treated MRI in a newborn with a BW of 273 g. According to the worldwide database held by the University of Iowa, he is registered as the tiniest male newborn in Europe. The boy was born in the 25th gestational week by cesarean section after a triplet pregnancy with twin–twin transfusion syndrome, him being the donor. He had a BW of 273 g, whereas his brothers had a BW of 740 g and 722 g. Cardiopulmonary stabilization and ventilation were successful. He developed MRI unresponsive to medical treatment. On day 14 of life, a minilaparotomy was performed in the right lower quadrant to externalize a loop of the distal ileum in a no-touch technique. Despite the small diameter of only 2 mm, a standard loop ileostomy could be fashioned. There were no intra- or postoperative abdominal complications. Bowel function and weight gain were adequate and the ileostomy was closed electively 5 months later at a body weight of 3.5 kg.

In summary, minilaparotomy and loop ileostomy placement were effective to treat surgical MRI in Europe's tiniest male newborn. With the advances of neonatology, pediatric surgery reaches new frontiers as well.



Publication History

Received: 01 September 2020

Accepted: 24 September 2020

Publication Date:
03 March 2021 (online)

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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