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Isolated ascites in a newborn with ‘apple peel’ jejunal atresia

Lookup NU author(s): Bruce Jaffray, Professor Nicholas Embleton

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Abstract

© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Isolated fetal ascites was diagnosed at 20 weeks in a primiparous woman with no significant medical history. Progressive fetal ascites worsened after 28 weeks and resulted in fetal hydroceles. Delivery was by caesarian section at 33 weeks, preceded by reduction of fetal ascites under ultrasound guidance. Following delivery, the baby required further reduction of abdominal fluid and endotracheal intubation to provide respiratory support. An extensive set of investigations, including metabolic and genetic screening, was performed; all results were negative. On day two of life, the baby developed bilious aspirates and an abdominal radiograph suggested intestinal obstruction. At laparotomy, an 'apple peel' jejunal atresia, abnormal mesentery with precarious blood supply and a proximal perforation were identified and the perforation 'sewn over'. The postoperative course was unremarkable, with Monogen feeds tolerated three weeks later. The baby continued to thrive at one year, tolerating increasing amount of long-chain fatty acids in diet.


Publication metadata

Author(s): Osmulikevici O, Renji E, Jaffray B, Embleton N

Publication type: Article

Publication status: Published

Journal: BMJ Case Reports

Year: 2017

Volume: 2017

Online publication date: 03/10/2017

Acceptance date: 15/09/2017

ISSN (print): 1757-790X

Publisher: BMJ Publishing Group

URL: https://doi.org/10.1136/bcr-2017-219781

DOI: 10.1136/bcr-2017-219781


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