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Paediatrics
Acute mesenteric ischaemia: a rare complication mimicking necrotising enterocolitis in a premature infant
  1. Siew-Boon Chan1,
  2. Benjamin Wei-Liang Ng1,2 and
  3. Chae-Hee Chieng1,2
  1. 1 Department of Paediatrics, Sibu Hospital, Ministry of Health Malaysia, Sibu, Sarawak, Malaysia
  2. 2 Faculty of Medicine, SEGi University, Kota Damansara, Selangor, Malaysia
  1. Correspondence to Dr Siew-Boon Chan; siewboonchan0104{at}gmail.com

Abstract

Acute mesenteric ischaemia (AMI) is a life-threatening gastrointestinal complication uncommonly described in premature infants. The diagnosis of AMI is challenging and may be delayed due to the limitation of accurate diagnostic imaging and non-specific clinical signs. Furthermore, AMI can be misdiagnosed as necrotising enterocolitis (NEC) due to the overlapping clinical and radiological features. Though known to be associated with high mortality rates, early recognition and intervention can improve the survival rates in infants with AMI. We describe a case of a premature infant who presented with an acute abdomen and haemodynamic collapse, initially treated for NEC but later diagnosed with AMI intraoperatively. Due to the extensive bowel necrosis, surgical intervention was rendered futile and the infant finally succumbed to the disease.

  • Paediatrics
  • Neonatal health
  • Surgery
  • Paediatric Surgery
  • Neonatal intensive care

https://doi.org/10.1136/bcr-2024-261723

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    Footnotes

    • Contributors The following authors were responsible for drafting the text, sourcing and editing clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: S-BC and BW-LN were responsible for drafting the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. C-HC was responsible for critical revision of important intellectual content. The following authors gave final approval of the manuscript: S-BC, BW-LN and C-HC gave final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.