Diagnosis and examination of intestinal malformations in newborns

There are many types of intestinal malformations in newborns. The symptoms vary depending on the specific location and degree of the malformation. Newborns may experience vomiting, loss of appetite, etc. Newborn intestinal malformations need to be diagnosed and examined before deciding whether to undergo surgery. The following is an introduction to this. I hope this can help everyone better understand this issue.

Neonatal intestinal malformation is a congenital intestinal developmental malformation in which the rectum and distal colon lack ganglion cells, leading to spasmodic stenosis of this section of the intestine. Its clinical characteristics include signs of low intestinal obstruction such as abdominal distension and constipation.

【Principles of diagnosis and treatment】

The child has no meconium or delayed excretion of meconium 2-3 days after birth, and may experience abdominal distension and vomiting, showing symptoms of acute low intestinal obstruction. Later, constipation and abdominal distension recurred and became progressively worse. There is obvious abdominal distension, intestinal pattern, shiny abdominal skin, engorged veins, and hyperactive bowel sounds. Digital rectal examination reveals spasm of the internal rectal sphincter and a feeling of emptiness in the ampulla, which can stimulate the defecation reflex. When the fingers are removed, more stool and gas are discharged. After the stool is discharged, the abdominal distension is relieved. The degree of intestinal obstruction varies greatly and is closely related to the pathological classification. The wider the lesion, the more severe the symptoms and signs. When enterocolitis occurs concurrently, constipation and diarrhea occur alternately, and the mortality rate of enterocolitis is very high.

【Auxiliary examination】：

1. X-ray abdominal films and barium enema contrast showed stenosis of the distal colon and proximal rectum and a highly dilated colon. The distal colon is funnel-shaped and has a distinct transitional segment.

2. Biopsy of the intestinal wall muscle layer of the rectal spasmodic segment confirmed the lack of ganglion cells.

3. Anorectal manometry to measure the reflex pressure changes of the rectum and anal sphincter.

4. The activity of acetylcholine esterase in rectal mucosa increases.

For all confirmed cases, regardless of type and age, non-surgical treatments such as enema can only temporarily relieve symptoms. For newborns, children with poor general condition or complicated by enterocolitis, it is preferred to undergo colostomy first, and then radical surgery after the general condition, intestinal obstruction and enterocolitis symptoms have improved. For patients with good general condition and no contraindications to surgery, at any age, including newborns, radical surgery should be performed as soon as possible, that is, the intestinal segment with no ganglion cells or with reduced and degenerated cells should be removed in the first stage, followed by proximal colon descent and anal anastomosis.

The above is the content about intestinal malformations in newborns. If you find that your child has this symptom, you should take him to the hospital for examination in time, so that everyone can rest assured. For more knowledge, you can follow the editor at any time, and the editor will contribute sincerely to everyone.