Surgery - Radiology - Pathology Rounds from The Montreal Children's Hospital: October 2, 2024


Neonatal Intestinal Pathologies

This session discussed two cases related to neonatal intestinal pathologies and their management. The first case involved a premature baby with significant bowel distension, and the importance of understanding rare anomalies in pediatric surgery. The second case included a term baby with dilated bowel loops, colonic atresia, and Hirschsprung disease. Also discussed were the challenges of frozen section analysis and biopsy in making a diagnosis.

Case 1. Spontaneous Intestinal Perforation

A 29-day-old premature male with a history of premature birth at 27 weeks was discussed, focusing on the baby's abdominal distension and the possibility of intestinal obstruction or pseudo-obstruction. The team analyzed a radiograph and performed a contrast enema to gather more information, concluding that the radiograph could represent a pseudo-obstruction. The conversation ended with a discussion on the pathology of the case, the examination of a resected segment of small bowel, and the rare condition of segmental intestinal dilatation.

Case 2. Total Colonic Hirschsprung Disease

A term baby with delayed meconium and bilious emesis was found to have a colonic atresia and potential Hirschsprung disease. The team deliberated on the challenges of diagnosing Hirschsprung's disease, the importance of pathology in such cases, and the findings from a biopsy. The team discussed the takedown of the anastomosis and the importance of considering Hirschsprung disease in cases of colonic atresia.


October 2, 2024 S - R - P Patient Case Discussions

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