Oclusión intestinal por enfermedad meconial asociada a hipotiroidismo y prematurez: reporte de un caso

Vinicio Xavier Jiménez Morejón; Diego PereiraNúñez Torrecilla; Nelson Carlos Juambeltz Dogliotti

doi:10.47464/MetroCiencia/vol28/2/2020/25-31

Authors

Vinicio Xavier Jiménez Morejón Centro Hospitalario Pereira Rossell y Universidad de la República Oriental del Uruguay https://orcid.org/0000-0002-6665-5072
Diego PereiraNúñez Torrecilla Centro Hospitalario Pereira Rossell y Universidad de la República Oriental del Uruguay https://orcid.org/0000-0003-4407-4194
Nelson Carlos Juambeltz Dogliotti Centro Hospitalario Pereira Rossell y Universidad de la República Oriental del Uruguay https://orcid.org/0000-0001-7957-4338

DOI:

https://doi.org/10.47464/MetroCiencia/vol28/2/2020/25-31

Keywords:

Meconium ileus, intestinal pseudoclusion, hypothyroidism

Abstract

Meconial Disease (MS) is a form of intestinal occlusion in the neonatal stage, in which the meconial content becomes thicker causing intraluminal occlusion. It represents, in up to 20% of cases, the first manifestation of Cystic Fibrosis (CF). It can also be a symptom of other pathologies such as hypothyroidism. The diagnosis is based on family history, findings of prenatal ultrasound and typical symptoms of intestinal occlusion at birth. The goal of treatment is to relieve intestinal occlusion through supportive measures, which mostly upset the clinical symptoms. The surgical intervention presents specific indications such as the failure in medical management or complicated meconial ileus. The case of a 29-week premature patient is presented, with a diagnosis of meconial disease due to hypothyroidism, in which surgical treatment was performed with good evolution.

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Author Biographies

Vinicio Xavier Jiménez Morejón, Centro Hospitalario Pereira Rossell y Universidad de la República Oriental del Uruguay

Residente de Cirugía Pediátrica de Clínica Quirúrgica Pediátrica; Montevideo, Uruguay
Diego PereiraNúñez Torrecilla, Centro Hospitalario Pereira Rossell y Universidad de la República Oriental del Uruguay

Profesor Adjunto de Clínica Quirúrgica Pediátrica; Montevideo, Uruguay
Nelson Carlos Juambeltz Dogliotti, Centro Hospitalario Pereira Rossell y Universidad de la República Oriental del Uruguay

Profesor y director de Clínica Quirúrgica Pediátrica; Montevideo, Uruguay

References

Flynn-O’Brien KT, Rice-Townsend S, Ledbetter DJ. Structural Anomalies of the Gastrointestinal Tract. Tenth Edit. Avery’s Diseases of the Newborn: Tenth Edition. Elsevier Inc.; 2017. 1039-1053.e3 p.

Hu Y-Y, Jensen T, Finck C. Surgical Conditions of the Small Intestine in Infants and Children. Eighth Edi. Shackelford’s Surgery of the Alimentary Tract, 2 Volume Set. Elsevier Inc.; 2019. 970–990 p.

Canizzaro C, Martínez Ferro M, Chattás G. Fetoneonatología Quirúrgica. Volumen 1. Aspectos Clínicos. Primera. Journal Ediciones, editor. Buenos Aires, Argentina; 2018. 707–719 p.

Martin KL, Kulaylat AN. Clinical Algorithms in General Surgery. Clin Algorithms Gen Surg. 2019;521–4.

Braun T, Henrich W. Intestinal Obstruction. Second Edi. Obstetric Imaging: Fetal Diagnosis and Care: Second Edition. Elsevier Inc.; 2017. 111-124.e3 p.

Al Jurayyan NAM, al Asmi MM, al Jurayyan RNA. Transient functional intestinal obstruction in a newborn: The first clinical manifestation of congenital hypothyroidism. Curr Pediatr Res. 2011;15(2):101–3.

Peterlini FL, Siviero-Miachon AA, Soares Martins-Moura EC, Spinola-Castro AM, de Faria Soares M de F, Batista de Morais M, et al. Untreated Congenital Hypothyroidism Mimicking Hirschsprung Disease: A Puzzling Case in a One-Year-Old Child. Case Rep Pediatr. 2018;2018:1–7.

Byun J, Han JW, Youn JK, Yang HB, Shin SH, Kim EK, et al. Risk factors of meconium-related ileus in very low birth weight infants: patients-control study. Sci Rep. 2020;10(1):1–6.

Sleeboom C, Heij H, Kneepkens C, Karimi A, Gorter R. Clinical and Genetic Characteristics of Meconium Ileus in Newborns With and Without Cystic Fibrosis. J Pediatr Gastroenterol Nutr. 2010;50(5):1.

Mayayo Dehesa E. Hipotiroidismo Y Bocio. Asoc Española Pediatría. 2011;150–65.

Mneimneh S, Rajab M, Hajar F. Case Report An Unusual Presentation of Congenital Hypothyroidism in a Newborn : Transient Pseudo-Obstruction. 2018;2(1):6–9.

Borowitz DS, Karamanoukian HL, Ragi JM, Burke MS, Irish MS, Kotter M, et al. New st rategies in nonoperative management of meconium ileus. J Pediatr Surg. 2002;37(5):760–4.

BRYK D. Meconium Ileus. Am J Roentgenol. 2013;95(1):214–6.

Sathe M, Houwen R. Meconium ileus in Cystic Fibrosis. J Cyst Fibros. 2017;16:S32–9.

Michikata K, Kodama Y, Kaneko M, Sameshima H, Ikenoue T, Machigashira S, et al. Oral diatrizoate acid for meconium-related ileus in extremely preterm infants. Pediatr Int. 2018;60(8):714–8.

Karimi A, Gorter RR, Sleeboom C, Kneepkens CMF, Heij HA. Issues in the management of simple and complex meconium ileus. Pediatr Surg Int. 2011;27(9):963–8.

González-Andrade F. Standardized clinical criteria and sweat test combined as a tool to diagnose Cystic Fibrosis. Heliyon. 2018;4(12).

Menchaca-Cervantes C, Rodríguez-Velasco A, Ramón-García G, Rendón-Macías ME. Enfermedad de Hirschsprung La inmunohistoquímica como apoyo para el diagnóstico. Rev Med Inst Mex Seguro Soc. 2013;51(6):610–3.

Frye RE. The Therapeutic Use of N-Acetylcysteine (NAC) in Medicine. The Therapeutic Use of N-Acetylcysteine (NAC) in Medicine. 2018.

Sellappan B, Chakraborty M, Cherian S. Congenital hypothyroidism presenting as pseudo-obstruction in preterm infants. BMJ Case Rep. 2014;1–3.

Scand P. CASE REPORT Congenital Hypothyroidism and Cystic Fibrosis. 1991;981–3.

Yenidoğanda B, Hiperbilirubinemi K, Şenayli Y, Şenayli A. Conjugated Hyperbilirubinemia in a Neonate with Meconium lleus and Congenital Hypothyroidism Mekonyum lleus ve Konjerıital Hipotrodizm Olan. 2008;(6):52–4.

Karim S, Islam K, Mitul AR, Noor-ul Ferdous KM, Hasan MS. Comparison of T Tube Ileostomy and Bishop Koop Ileostomy for the Management of Uncomplicated Meconium Ileus. J Neonatal Surg. 2017;6(3):56.

Orgul G, Soyer T, Yurdakok M, Beksac MS. Evaluation of pre- and postnatally diagnosed gastrointestinal tract obstructions. J Matern Neonatal Med. 2018;7058:1–6.

Osifo O, Okolo J. Neonatal intestinal obstruction in Benin, Nigeria. African J Paediatr Surg. 2009;6(2):98.

Mohammed M, Amezene T, Tamirat M. Intestinal Obstruction in Early Neonatal Period: A 3-Year Review Of Admitted Cases from a Tertiary Hospital in Ethiopia. Ethiop J Health Sci. 2017;27(4):393.

Rodr R, Arag P. Aeped Pediatria.

Fakhoury K, Durie PR, Levison H, Canny GJ. Meconium ileus in the absence of cystic fibrosis. Arch Dis Child. 1992;67(10 SPEC NO):1204–6.

Gulcan H, Gungor S, Tiker F, Kilicdag H. Effect of perinatal factors on time of first stool passage in preterm newborns: An open, prospective study. Curr Ther Res - Clin Exp. 2006;67(3):214–25.

Abushanab DH, Alsoukhni OA, Al-Badriyeh D. Evaluations of Morphine and Fentanyl for Mechanically Ventilated Patients With Respiratory Disorders in Intensive Care: A Systematic Review of Methodological Trends and Reporting Quality. Value Heal Reg Issues. 2019;19:7–25.

Wallis C. Diagnosis and Presentation of Cystic Fibrosis. Ninth Edit. Kendig’s Disorders of the Respiratory Tract in Children. Elsevier Inc.; 2018. 769-776.e2 p.