2020 Volume 56 Issue 1 Pages 91-94
We examined a low-birth-weight 1-day-old male neonate by abdominal contrast-enhanced computed tomography (CT), which revealed splenic damage (IIIb). Conservative treatment was successful in this patient. His mother experienced premature labor and labor pains at 27 weeks and 5 days of gestation, and urgently gave birth through Cesarean section. There was no difficulty in the delivery of the infant. His birth weight was 1,085 g, and his Apgar score was 8/7. He developed respiratory distress syndrome. Artificial respiration was used, and the patient was managed via intratracheal intubation 8 min after birth. He experienced entire-body pallor 16 h after birth, accompanied by abdominal swelling. The level of hemoglobin was 5.7 g/dl. Abdominal ultrasonography revealed abdominal dropsy and a hematoma in the splenic hilum. However, we were unable to diagnose the nature of damage to the spleen. Therefore, we performed examinations by abdominal contrast-enhanced CT via the intravenous administration of iopamidol (70% of the usual quantity). The results revealed complex deep spleen injury (IIIb) without hilar vessel injury. We initiated conservative therapy through blood transfusion. For the examination of newborns by CT, the use of contrast media is not recommended. However, we can safely perform this examination by fluid infusion after inspection to avoid renal failure due to the use of contrast media. This approach allows us to obtain useful information from images obtained by CT using contrast media.
