Difficulty in diagnosis and management of postoperative colostomy-related complications n a very low birthweight infant

Abstract

A girl weighing 322 g was born at 23 weeks of gestation by emergency cesarean section due to cardiac failure caused by maternal hypertension. She had delayed fecal excretion and abdominal distension, and developed gastrointestinal perforation on the eighth day of life. The baby was treated conservatively due to prematurity, and a colostomy was performed at 36 days of age. The postoperative diagnosis was intestinal distension caused by true diverticula. Enteral feeding was resumed after the operation, but at 90 days of age the stoma was inverted and prolapsed. Although manual repair was performed, the respiratory and circulatory dynamics gradually deteriorated with repeated prolapses and she died at 95 days of age. Intestinal intussusception in neonates is rare and difficult to diagnose pre-operatively because of its nonspecific symptoms. Proctocolectomy in extremely low birthweight infants is a difficult procedure with many complications.