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Focal intestinal perforation in extremely-low-birth-weight neonates: etiological consideration from histological findings.

Focal intestinal perforation in extremely-low-birth-weight neonates: etiological consideration from histological findings. Research Abstract Details 

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  • Focal intestinal perforation in extremely-low-birth-weight neonates: etiological consideration from histological findings. Abstract Text:

    akio kubotaAkio Kubota,hiroaki yamanakaHiroaki Yamanaka,hiroomi okuyamaHiroomi Okuyama,jun shiraishiJun Shiraishi,hisayoshi kawaharaHisayoshi Kawahara,toshimichi hasegawaToshimichi Hasegawa,takehisa uenoTakehisa Ueno,hiroyuki kitajimaHiroyuki Kitajima,yuko kuwaeYuko Kuwae,masahiro nakayamaMasahiro Nakayama,akio kubotaAkio Kubota,hiroaki yamanakaHiroaki Yamanaka,hiroomi okuyamaHiroomi Okuyama,jun shiraishiJun Shiraishi,hisayoshi kawaharaHisayoshi Kawahara,toshimichi hasegawaToshimichi Hasegawa,takehisa uenoTakehisa Ueno,hiroyuki kitajimaHiroyuki Kitajima,yuko kuwaeYuko Kuwae,masahiro nakayamaMasahiro Nakayama,

    In Japan, mortality due to intestinal perforation has been increasing for the last 15 years, as the survival rate of extremely-low-birth-weight neonates (ELBWs) has been increasing. In our NICU, although the incidence of necrotizing enterocolitis has been decreasing, that of focal intestinal perforation (FIP) has been increasing. To elucidate the pathogenesis of FIP, a histological study was performed. For the last 20 years, in our NICU, 11 ELBWs with FIP, including one with multiple perforations and impending rupture, underwent laparotomy and enterostomy. The intestinal wall around the perforation was resected for histological study. Histological studies revealed well-developed ganglion cells in all the cases. Although some lymphocytic infiltration and hemorrhage were observed, no apparent neutrophilic infiltration, or necrotic change was identified in any case. No evidence of microcirculatory impairment was identified. The intestinal musculature discontinued abruptly with thinning in three cases, and without thinning in the others. The histology of impending rupture showed an absence of the muscularis with preservation of the remaining components of the bowel wall. The findings that the punched-out perforations had the appearance of Hirschsprung's disease, FIP exclusively occurred in ELBWs, and that neither mechanical obstruction nor necrotic change could be identified as the cause of the perforation suggest that immature bowel movement and congenital muscle defects may be involved in the pathogenesis of FIP.

    Focal intestinal perforation in extremely-low-birth-weight neonates: etiological consideration from histological findings. Publishing Authors By Initials

    a kubotaA Kubota,h yamanakaH Yamanaka,h okuyamaH Okuyama,j shiraishiJ Shiraishi,h kawaharaH Kawahara,t hasegawaT Hasegawa,t uenoT Ueno,h kitajimaH Kitajima,y kuwaeY Kuwae,m nakayamaM Nakayama,a kubotaA Kubota,h yamanakaH Yamanaka,h okuyamaH Okuyama,j shiraishiJ Shiraishi,h kawaharaH Kawahara,t hasegawaT Hasegawa,t uenoT Ueno,h kitajimaH Kitajima,y kuwaeY Kuwae,m nakayamaM Nakayama,

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    Focal intestinal perforation in extremely-low-birth-weight neonates: etiological consideration from histological findings. Journal Published:

    PUBLICATION TYPE: Journal Article

    Journal: Pediatric surgery international

    VOLUME: 23

    Page Numbers: 997-1000

    Journal Abbreviation: Pediatr. Surg. Int.

    ISSN: 0179-0358

    DAY: 18

    MONTH: Oct

    YEAR: 2007

    Focal intestinal perforation in extremely-low-birth-weight neonates: etiological consideration from histological findings. Information

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    LANGUAGE: eng

    NlmUniqueID: 8609169

    Focal intestinal perforation in extremely-low-birth-weight neonates: etiological consideration from histological findings. Keywords Mesh Terms:

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    Grant and Affiliation Information for Focal intestinal perforation in extremely-low-birth-weight neonates: etiological consideration from histological findings.

    AFFILIATION: Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan. kubota@mch.pref.osaka.jp

    Country: Germany

    Germany Research PublicationGermany Research Publication

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    MEDLINETA: Pediatr Surg Int

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