Neonatal colon perforation (신생아 장 천공)
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- 2011.10.26
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- 2011.10
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소개글
Neonatal colon perforation에 관한 발표 자료 입니다.
Neonatal colon perforation에 대해서 발표를 준비하거나 공부를 하시는 분께 도움이 되리라 생각합니다.
목차
Hirshprung’s disease
NEC
Meconuim syndrome
Left small bowel syndrome
본문내용
Hirshprung’s disease
NEC
Meconium syndrome
Left small bowel syndrome
Hirshprung’s disease
NEC
Meconium syndrome
Left small bowel syndrome
[CLINICAL MANIFESTATIONS]
full-term infant (the disease is unusual in preterm infants)
-delayed passage of stool.
[embrylolgy]
neuroenteric cell-5주 esophagus- 7주 midgut- 12주 distal colon
Migration: auerbach(intramuscular) plexus->meissner(submucosa)
fibronectin, hyalunic acid, neural growth factor
[pathophysiology]
3가지 neuronal plexus: 정상 환경에서 relaxation dominant
Ganglionic cell-extrinsic nerve system develop-adrenergic 활성
-smooth m. ↑
[Diagnosis]
[rectal suction biopsy]
procedure of choice : 2 cm to the dentate line
Mucosa&submucosa : evaluate for the presence of ganglion cells.
acetylcholinesterase: hypertrophied nerve bundles
acetylcholinesterase (+)
ganglion cells(-)
Cf) Full-thickness rectal biopsy can be performed at the time of surgery to confirm the diagnosis and level of involvement
Hirshprung’s disease
[Anorectal manometry]
internal anal sphincter pressure.
Normal: rectal distention-internal sphincter pressure↓
Hirschsprung disease: paradoxical rise rectal distention.
The accuracy >90%, technically difficult to perform
[radiographic diagnosis]
transition zone:
참고 자료
▶Pediatric surgery 6th edition /Jay L.Grosfeld, james A.O’Neill, Jr. /
▶Nelson textbook of Pediatrics 18th / Saunders 2007 /
▶Harrison’s Principles of Internal Medicine 17th / McGrawHill Medical/ Chapter
▶Townsend : Sabiston textbook of surgery 18th