|
 
 |
| CLINICAL QUIZ |
|
| Year : 2023 | Volume
: 3
| Issue : 3 | Page : 198-199 |
|
A newborn with distended abdomen (questions)
Aayushi Joshi1, Utkarsh Sharma1, Madhukar Maletha2
1 Department of Paediatrics, SMIH, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
2 Department of Paediatric Surgery, SMIH, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| Date of Submission | 04-May-2023 |
| Date of Decision | 05-Jul-2023 |
| Date of Acceptance | 09-Jul-2023 |
| Date of Web Publication | 14-Aug-2023 |
Correspondence Address:
Dr. Aayushi Joshi
House No. 6, Phase 2, Prakash Lok Colony, Shimla Bypass Road, Dehradun, Uttarakhand
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/ipcares.ipcares_106_23
How to cite this article:
Joshi A, Sharma U, Maletha M. A newborn with distended abdomen (questions). Indian Pediatr Case Rep 2023;3:198-9 |
A preterm (34 weeks) female was born via LSCS, to a high risk elderly multigravida, unbooked pregnancy with uncontrolled gestational diabetes. The baby cried immediately after birth, with an APGAR score of 7/8. The baby was found to have massive abdominal distension and thus shifted to the neonatal intensive care unit.
On examination, Patient vitals- heart rate 130/min, respiratory rate 44/min, with SpO2 95% in room air, warm peripheries and well palpable pulses, with a capillary filling time of <2 seconds.The baby was large for gestational age, with a birth weight of 2.8 kg, length of 52.3 cm, and head circumference of 35 cm.
Abdominal examination revealed a grossly distended abdomen with appearance, as shown in [Image 1]. The abdomen was soft, nontender on palpation with 2–3 palpable masses around the umbilicus, largest measuring 2.5 cm × 2.4 cm in diameter. No fluid thrill or shifting dullness was appreciable and normal bowel sounds were heard. Other systems was within the normal limits.
The baby was kept nil by mouth with and a nasogastric tube in situ, and started on supportive treatment with intravenous fluids. The baby passed meconium after an hour of birth and urine within 12 hours of birth. Subsequently, 2–3 stools were passed per day, which did not have blood or mucus. There was no vomiting or bilious nasogastric aspirate.
Baseline investigations showed hemoglobin of 14.7 g/dl, total leukocyte count of 18,300 cumm, platelets 4.2 lakhs/cumm, serum sodium 139 mmol/l, potassium 5.6 mol/l, blood urea 22 mg/dl, serum creatinine 0.9 mg/dl, and C-reactive protein 1.68 mg/l. The contrast-enhanced computed tomography (CECT) of the abdomen was done, as shown in [Image 2].
| Questions | |  |
- Mention the salient findings of CECT abdomen, as shown in Image 2
- Based on the clinical presentation and the investigations, what is the likely diagnosis?
- What is the most common site of occurrence?
- What is the current line of management?
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the legal guardian has given his consent for images and other clinical information to be reported in the journal. The guardian understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
Acknowledgment
I would like to thank my mentors for their guidance and support – Dr. Utkarsh Sharma and Dr. Madhukar Maletha – whose sound clinical sense and discipline is a source of inspiration. I am forever grateful for the love and encouragement bestowed by my parents and loved ones.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
|
Search Pubmed for