Violations of mesenteric blood flow in newborn and young children

Abstract

Disturbances of mesenteries blood circulations bring to bad course of basic pathology and became the reasons of lethal outcome in 80-100%. The problems are timely revealing of this complication in newborns and infants and adequate treatment of it.The aim of the work was analysis of cases of acute mesenteries ischemia (AMI) in newborns and infants and improvement of their treatment due to comprehensive assessment of clinical, laboratory and instrumental data.Materials and methods : 21 child with different pathology complicated AMI was treated in Odessa Regional Pediatric Hospital from 2010 to 2015.Results :There was Ladd’s syndrome, acute enterocolitis, acute idiopathic thrombosis of mesenteric vessels, antyphospholipid syndrome, thromboembolic of mesenteries veins and isolated torsion of enteral loop. 18 (85,7%) of children were operated on and 8 (38,1%) patients died. Nonocclusive and combined types of AMI prevail in newborns and infants. The stages of AMI: ischemia, infarct of intestine and peritonitis has rapid current without clear clinical signs of every stage. Clinical criteria AMI are development of signs of shock without predictors, decreasing or absence of peristalsis in small signs of intraperitoneal catastrophe. Laboratory criteria of AMI are rapid decreasing of hemoglobin rate without bleeding or hematoma. X-Ray reveals absence of gas in intestine or free gas in system of portal vein. Ultrasound with Doppler assists in early revealing of mesenteric ischemia. Surgical treatment in AMI mast be performed before intestinal infarct develops.