Gastrointestinal sistem cerrahi patolojilerine eşlik eden konjenital anomalilerin değerlendirilmesi

Year 2019, Volume: 44 Issue: 2, 425 - 430, 30.06.2019

Murat Konak , Ahmet Sert , Metin Gündüz , Hanifi Soylu , Saime Sündüs Uygun

https://doi.org/10.17826/cumj.458835

Cited By: 3

Abstract

Amaç: Bu çalışmanın amacı gastrointestinal sistemin cerrahi patolojilerine eşlik eden konjenital anomalileri değerlendirmektir.

Gereç ve Yöntem: 2015-2018 yılları arasında yenidoğan yoğun bakım ünitesine gastrointestinal sistem cerrahi patolojileri nedeniyle başvuran hastaların tıbbi kayıtları retrospektif olarak ilişkili konjenital anomaliler açısından değerlendirildi.

Bulgular: Çalışma süresince 67 hasta tespit edildi. En sık rastlanan gastrointestinal sistem patolojisi 15 olguda (% 22.4) anal atrezi, bunu 14 olguda (% 20.9) diyafragma hernisi, özofagus atrezisi (n: 10) ve ileal atrezi (n: 10) (% 14.9) izledi. Otuz iki hastada (% 48.8) gastrointestinal sistem patolojilerine eşlik eden konjenital anomali saptandı. Konjenital kalp hastalığı en sık görülen anomaliydi ve en sık birliktelik 18 olguda (% 26.8) atriyal septal defekt idi. Ek olarak, (n: 13)% 19.4'ünde kompleks konjenital kalp hastalığı vardı. On iki hastaya (% 17.9) ekstrakardiyak anomaliler eşlik etmekteydi. Üç hastada (% 4.5) hidronefroz ve safra kesesi çamuru vardı. Vezikoüreteral reflü, ektopik böbrek veya polispleni, her bir olguda ayrı bir anomali olarak tespit edildi. Olgularımızın % 54’ü prematüre olarak doğmuştu.

Sonuç: Gastrointestinal sistem patolojileri sıklıkla konjenital kalp hastalıkları gibi çoklu anomaliler ile ilişkilidir. Ek olarak, GIS patolojilerinin prematüre bebeklerde daha sık görülmesi muhtemeldir.

Keywords

newborn, gastrointestinal pathologies

Evaluation of congenital anomalies accompanying to gastrointestinal system surgical pathologies

Abstract

Purpose: The aim of this study was to review accompanied congenital anomalies to gastrointestinal pathologies. 

Materials and Methods: The medical records of patients who were admitted to neonatal intensive care unit with gastrointestinal system surgical pathologies during 2015-2018 were retrospectively evaluated for associated congenital anomalies.

Results: 67 patients were identified during the study period. The most common gastrointestinal system pathology was anal atresia in 15 cases (22.4%), followed by diaphragmatic hernia in 14 cases (20.9%), esophageal atresia (n:10) and ileal atresia (n:10) (14.9%). Thirty two patients (48.8%) have had accompanied congenital anomalies to gastrointestinal system pathologies. Congenital heart disease was the most common anomaly and the most frequent one was atrial septal defect in 18 cases (26.8%). In addition, there was complex congenital heart disease in (n:13) 19.4%. In 12 patients (17.9%), accompanied extracardiac anomalies were detected. Hydronephrosis and sludge in gall bladder were detected in three patients (4.5%). Vesicoureteral reflux or ectopic kidney or polysplenia was detected as a separate anomaly in each case. In our cases, prematurity rate was found in 54%.

Conclusion: Gastrointestinal system pathologies are frequently associated with multiple anomalies, especially with congenital heart diseases. In addition, these patients are likely to be preterm baby. 

Keywords

newborn, gastrointestinal pathologies

References

• 1. Olgun H, Karacan M, Caner I, Oral A, Ceviz N. Congenital cardiac malformations in neonates with apparently isolated gastrointestinal malformations. Pediatr Int. 2009; 51: 260-2.
• 2. Güney LH, Araz C, Beyazpınar DS, Arda İS, Arslan EE, Hiçsönmez A. Abdominal problems in children with congenital cardiovascular abnormalitie. Balkan Med J. 2015; 32: 285-90.
• 3. Rosa RC, Rosa RF, Zen PR, Paskulin GA. Congenital heart defects and extracardiac malformations. Rev Paul Pediatr. 2013; 31: 243-51.
• 4. Chirdan LB, Uba AF, Pam SD. Intestinal atresia: management problems in a developing country. Pediatr Surg Int. 2004;20:834-7.
• 5. Sayan A, Arıkan A, Okay ST, Şimşek FN, Bayol Ü, Özer HN, et al. Cerrahi yenidoğanlarda ek anomaliler. Çocuk Cerrahisi Dergisi. 2016; 22(3), 104-110.
• 6. Sarsu SB, Şahin K, Sezer S. Yenidoğanın Gastrointestinal Sistem Malformasyonları ile Birlikte Görülen Doğumsal Kalp Hastalıkları. The Journal of Pediatric Research 2015;2(4):197-200.
• 7. Tulloh RM, Tansey SP, Parashar K, De Giovanni JV, Wright, JG, Silove ED. Echocardiographic screening in neonates undergoing surgery for selected gastrointestinal malformations. Archives of Disease in Childhood-Fetal and Neonatal Edition. 1994; 70(3), F206-F208.
• 8. Chéhab G, Fakhoury H, Saliba Z, Issa Z, Faour Y, Hammoud D, et al. Congenital heart disease associated with gastrointestinal malformations. J Med. Liban. 2007 ; 55 : 70 – 74.
• 9. Russell LJ, Weaver DD, Bull MJ. The axial mesodermal dysplasia spectrum. Pediatrics 1981; 67 : 176 – 82.
• 10. Ratan SK, Rattan KN, Pandey RM, Mittal A, Magu S, Sodhi PK. Associated congenital anomalies in patients with anorectal malformations: A need for developing a uniform practical approach. J Pediatr Surg. 2004 ; 39 : 1706 – 11.
• 11. Guyer B, MacDorman MF, Martin JA, Peters KD, Strobino DM. Annual summary of vital statistics—1997. Pediatrics. 1998; 102(6), 1333-1349.
• 12. Greenwood RD, Rosenthal A, Nadas AS. Cardiovascular malformations associated with omphalocele. J. Pediatr. 1974 ; 85 : 818 – 21.
• 13. Greenwood RD, Rosenthal A, Nadas AS. Cardiovascular malformations associated with imperforate anus. J. Pediatr. 1975; 86 :576 – 9.
• 14. Cuschieri A: EUROCAT Working Group. Anorectal anomalies associated with or as part of other anomalies. Am J Med Genet. 2002; 110:122-30.
• 15. Stoll C, Alembik Y, Dott B, et al: Omphalocele and gastroschisis and associated malformations. Am J Med Genet. 2008; 146:1280-5.
• 16. St-Vil D, Shaw KS, Lallier M, et al: Chromosomal anomalies in newborns with omphalocele. J Pediatr Surg. 1996; 31:831-4.
• 17. Colvin J, Bower C, Dickinson JE, Sokol J. Outcomes of Congenital Diaphragmatic Hernia: A Population-Based Study in Western Australia. Pediatrics. 2005; 116:356-63.
• 18. Tovar JA. Congenital diaphragmatic hernia. Orphanet J Rare Dis. 2012;7(1), 1.
• 19. Stege G, Fenton A, Jaffray B: Nihilism in the 1990s: the true mortality of congenital diaphragmatic hernia. Pediatrics. 2003; 112: 532-535.
• 20. Graziano JN. Cardiac anomalies in patients with congenital diaphragmatic hernia and their prognosis: a report from the Congenital Diaphragmatic Hernia Study Group. J Pediatr Surg. 2005; 40:1045-50.
• 21. Kumar A, Singh K. Major congenital malformations of the gastrointestinal tract among the newborns in one of the English Caribbean Countries, 1993 - 2012. J Clin Neonatol. 2014; 3: 205-10.
• 22. Encinas JL, Luis AL, Avila LF, Martinez L, Guereta L, Lassaletta L, et al. Impact of preoperative diagnosis of congenital heart disease on the treatment of esophageal atresia. Pediatric Surgery International. 2016;22(2), 150–153.
• 23. Donoso F, Kassa AM, Gustafson E, Meurling S, Lilja HE. Outcome and management in infants with esophageal atresia—a single centre observational study. J Pediatr Surg. 2016; 51(9), 1421–1425.
• 24. Best KE, Tennant PW, Addor MC, Bianchi F, Boyd P, Calzolari, E, et al. Epidemiology of small intestinal atresia in Europe: a register-based study. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2012; fetalneonatal-2011-300631.
• 25. Takahashi D, Hiroma T, Takamizawa S, Nakamura T. Population‐based study of esophageal and small intestinal atresia/stenosis. Pediatr Int. 2014; 56(6), 838-844.
• 26. Walker K, Badawi N, Hamid CH, Vora A, Halliday R, Taylor C, et al. A population-based study of the outcome after small bowel atresia/stenosis in New South Wales and the Australian Capital Territory, Australia, 1992-2003. J Pediatr Surg. 2008; 43(3), 484-488.