Unexplained Abdominal distension in a7 days old male baby

Author: Jasbir S Chugh, Dept of Pediatrics, SNS Pahwa Hospital, Ludhiana, Email: drjc48@yahoo,com

Question
A male baby delivered at full term by LSCS {Indicated for reduced fetal movements, poor progress in labor}. Mother is second gravid with no bad obstetrical history and no antenatal or postnatal complication. No history of premature rupture of membranes. There is no significant maternal illness. Baby cried and gasped immediately and did not require any assisted mode of resuscitation. Birth weight was 2.9 kg with head circumference of 33cm, length of 49cm. On examination: NAD. Blood group of mother is AB Positive and baby is B positive. Screening for HIV and HBsAg is negative. Baby was started on breast feed after few initial feeds of 5 percentD orally. The baby developed mild icterus {S. bilirubin = 10.4, direct of 0.9} on day 3 and did not require any treatment for that. Bbay developed abdominal distension on Day 7. Was active, not sick or toxic looking, taking breast feed normal. No vomiting, regurgitation or respiratory distress. Passing semi formed stools without blood or mucus. Abdomen distended and tense, no visible peristalsis. No distended bowel loops. Bowel Sounds increased. No palpable mass. Rectal canal normal. Investigations showed X-ray upright abdomen - Right colon appeared to be distended. USG abdomen: NAD.
• TLC: HB: 15.4Gm` 13000, P76 percent L 23 percent, E 1 percent .MP not seen
• Routine Stool: Ph 6, Reducing substance nil, Microscopy: NAD
• Routine Urine: NAD
• CR Protein normal. G6PD normal.
• Se Electrolytes: Na: 136 meq` K: 4.8` Cl: 104
• BUN 10` Se creatinine 0.6
• Blood sugar: 62
• Se calcium: 8.8 Phos: 4.6 Alkaline phos. 220 i.u
• Urine. Stool, blood cultures: no growth.
Baby passing semi loose stools, no vomiting.
Treatment: Baby was kept Nil PO and continuous N, G drainage. Iv fluids and antibiotics were given. Nasogastric aspirate non-bilious and amount normal. Distension was persisting so a repeat upright, and lateral x-ray abdomen was done but it was non conclusive. Baby was referred for pediatric surgery consultation and we lost track after that.

What could be the possible cause of Abdominal distension. Hirshprung disease_?_? partial malrotation_?_?_? NEC

What could be the possible cause of Abdominal distension_?

Answer Discussion :

rashidghori

Hirshprung disease

15 years ago

amlcash adv

Hirshspring disease

15 years ago

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Unexplained Abdominal distension in a7 days old male baby

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