Midgut agenesia (clinical and forensic medical aspects): a rare case report

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Abstract

Background: Congenital obstruction of the gastrointestinal tract in the form of complete atresia occurs in newborns in 60% of all cases of obstruction of the digestive tract, while agenesis of the derivative of the midgut is a rather rare defect.

Case presentation: After birth, the child in this case was repeatedly operated on for congenital intestinal obstruction. Most of the jejunum, ileum, cecum, ascending, right half of the transverse colon were absent in the child, and an anastomosis was performed between the jejunum and transversum. In the postoperative period, it was not possible to cope with the intestinal and protein -energy deficiency and the child exerted at home. The section has confirmed clinical diagnoses.

Conclusion: The authors draw attention to the possibility of resorption of the extraperitoneally located intestine at the end of the first period of intrauterine rotation with a possible vascular and/or ischemic disaster.

About the authors

Alexey E. Maltsev

Kirov Regional Bureau of Forensic Medicine

Email: al.maltsev@mail.ru
ORCID iD: 0000-0001-7756-6959
SPIN-code: 4371-2000

Dr. Sci. (Med.), Prof., Head of the KRBFM "Kirov Regional Bureau of Forensic Medicine"

Russian Federation, Kirov

Maxim P. Razin

Federal State Budgetary Educational Institution of Higher Education «Kirov State Medical University» of the Ministry of Healthcare of the Russian Federation

Email: mprazin@yandex.ru
ORCID iD: 0000-0003-3561-3256
SPIN-code: 6868-2750

Dr. Sci. (Med.), Prof.

Russian Federation, Kirov

Valentin A. Skobelev

Federal State Budgetary Educational Institution of Higher Education «Kirov State Medical University» of the Ministry of Healthcare of the Russian Federation

Author for correspondence.
Email: kf12@kirovgma.ru
ORCID iD: 0000-0002-9272-9055
SPIN-code: 5489-7583

PhD

Russian Federation, Kirov

Anna Y. Schukhina

Federal State Budgetary Educational Institution of Higher Education «Kirov State Medical University» of the Ministry of Healthcare of the Russian Federation

Email: annacool23@mail.ru
ORCID iD: 0000-0002-2009-9998
SPIN-code: 6931-0274

Postgraduate student of the Department of Pediatric Surgery

Russian Federation, Kirov

References

  1. Morozov DA, Filippov YuV, Gorodkov SYu, et al. Surgery for congenital small bowel obstruction. Russian journal of pediatric surgery, anesthesia and intensive care. 2011;(2):21–29. (In Russ.)
  2. Kucherov YuI, Kulakov VI, Zhirkova YuV, et al. Family case of colon atresia. Russian journal of Pediatric surgery. 2006;(5): 50–51. (In Russ.)
  3. Razin MP, Zheleznov LM. To the question of teratogenesis of gastroschisis. Russian journal of Pediatric surgery. 2018;22(6): 321–322. (In Russ.) doi: 10.18821/1560-9510-2018-22-6-321-322
  4. Tsap NA, Besaliev BN. A modern view of gastroschisis: from the antenatal period to the outcome of treatment (literature review). литературы). Russian journal of pediatric surgery, anesthesia and intensive care. 2011;(2):45–62. (In Russ.)
  5. Feldkamp ML, Botto LD, Byrne JL, et al. Clinical presentation and survival in a population-based cohort of infants with gastroschisis in Utah, 1997–2011. Am J Med Gen Part A. 2016; 170(2):306.
  6. Kozlov YuA, Novozhilov VA, Koval’kov KA, et al. Congenital abdominal wall defects. N.I. Pirogov Journal of Surgery. 2016;(5):74–81. (In Russ.)
  7. Islam S. Gastroschisis. Fundamentals of Pediatric Surgery: Springer, Cham; 2017. Р. 569–574.

Supplementary files

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2. Fig. 1. Scheme of the first stage of physiological rotation of the fetal intestine (physiological hernia)

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3. Fig. 2. Antenatal ultrasound of a fetus with gastroschisis and an imaging scheme of the defect (the arrow indicates the extraperitoneally located intestine)

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4. Fig. 3. Schematic intraoperative representation of a congenital malformation of the intestine

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Copyright (c) 2021 Maltsev A.E., Razin M.P., Skobelev V.A., Schukhina A.Y.

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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