Unnecessary surgical treatment should be avoided for neonata
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Neonatal small left colon syndrome (NSLCS) is a rare disease involving gastrointestinal functional obstruction. NSLCS develops in association with gestational diabetes and it often recovers spontaneously. Doctors operated on an infant with NSLCS and discuss how surgery could potentially be avoided.

Doctors report a case of neonatal small left colon syndrome (NSLCS) that underwent surgery. A female infant was born at 38 weeks of gestation. The mother had gestational diabetes requiring insulin therapy. The baby was admitted for respiratory distress.

Abdominal distension was observed, and the gastric residue increased. The contrast enema revealed a small caliber of the left colon up to the splenic flexure. At 14 days, the full-thickness biopsy of the sigmoid and transverse colons was performed. Pathological diagnosis showed that the sigmoid colon had few ganglion cells, therefore the transverse colostomy was performed. At 6 months of age, a rectal biopsy was performed to confirm the diagnosis of Hirschsprung’s disease; the intestinal plexus and ganglion cells were normal.

The surgery was changed from a pull-through to a stoma closure. The postoperative diagnosis was NSLCS, and the course of up to 3 years was good without defecation or growth problems.

Journal of Surgical Case Reports
Source: https://doi.org/10.1093/jscr/rjab072
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