Imagine being born with perforations in your intestine. It can be everything BUT a pleasant experience.
A full-term male baby born through a normal vaginal delivery got admitted to hospital just after 27 days of birth. The new-born weighed 3.2 kg and was born to a prima gravid mother. He did not have any history of intrauterine stress or premature rupture of membranes. His admission however took place on grounds of abdominal distension and vomiting for 2 days.
Examination
Upon physical examination, the baby displayed a distended abdomen with absent bowel sounds, fever and cool limbs. Blood count came out to be 14780/micro liter for white blood cells with 81 percent of the population being neutrophils. Also, it revealed a raised CRP (C reactive protein) with slight anemia and a normal platelet count.
An abdominal X-ray clearly showed gas below the diaphragm. Hence, the doctors gave intravenous imipenem to the patient and opted for an abdominal surgery right away.
Surgery Reveals Multiple Perforations
The surgery revealed quite some damages to the patient’s intestine. It showed yellowish-greenish pus with multiple areas of necrosis along the length of the entire small intestine. Moreover, it revealed 58 circular perforations resting on a bed of black necrotic bowel tissue and blood red protrusions.
The doctors resected the necrotic tissue and repaired the perforations. They sent the resected masses for histological assays. The results revealed the presence of large number of inflammatory cells, both acute and chronic. They also showed local congestion and edema along with dilation of local blood vessels.
But What Caused the Perforations?
A pathological analysis of venous blood plus the peritoneal exudate indicated the presence of Pseudomonas aeruginoasa. This led to a diagnosis of intestinal perforations caused by bacteremia with P. aeruginoasa.
Post- Operative Events
The patient showed a good post-operative progress. He did not develop any complications such as fistulas or infections. He got discharged on the 17th day post-surgery and has been in perfect health ever since.
