2023 Volume 59 Issue 1 Pages 56-60
The patient was a 24-day-old girl who was born at 38 weeks and 4 days of gestation and weighed 3,055 g. She was admitted to a previous hospital for frequent vomiting. Computed tomography on the next day showed that she had strangulating intestinal obstruction. She was in compensated shock at the time of transfer to our hospital and resuscitation was started immediately. Emergency surgery was essential, but the operating room was not available, so we performed derotation and siloplasty in the neonatal intensive care unit. The patient’s circulatory and respiratory condition was stabilized after the surgery, and radical surgery (second-look operation: SLO) was performed in the operating room three hours after the initial surgery. Intraoperatively, the patient was diagnosed as having intestinal volvulus without malrotation; 130 cm of the ischemic small intestine was resected, and the ileocecum was preserved. Within one year after the surgery, there were no problems with her growth and development. The first priority of treatment of neonatal strangulating intestinal obstruction is to release the strangulation mechanism as soon as possible. Although SLO has been considered the treatment strategy for preserving a strangulated intestine, early derotation and siloplasty until radical surgery are reconfirmed to be very useful as part of emergency resuscitation.
