Surgery I, II - lecture

Congenital disorders (birth defects)

-          organ defects that occur during prenatal development of the fetus and are present at birth. They affect to varying degrees about 3% of newborns.

 

·         Atresia - congenital intestinal obstruction - it may be just a persistent membrane in the lumen of the intestine that prevents passage, or a complete disruption of intestinal continuity

·         Stenosis - narrowing of the intestinal lumen

·         Failure of rotation of the colon or its attachment to the posterior abdominal wall - nonrotation, incomplete rotation (cecum lies above the duodenojejunal junction) or reverse rotation (clockwise rotation) - a common complication is volvulus and duodenal obstruction

·         Ladd's syndrome - bowel rotation disorder in combination with congenital midgut volvulus and compression of the duodenum by a non-rotated cecum



Miroslav Zeman, Zdeněk Krška, coll.  Special surgery. 2014


·         Isolated high cecal position - this is an incomplete rotation of the cecum, which is located in the right hypochondrium (this birth disorder can be clinically completely silent)

·         Hirschprung's disease - is caused by the absence of ganglion cells (plexus myentericus Auerbachi and plexus submucosus Meissneri) in the wall of the large intestine in various extent - from m.sphincter ani internus proximally. This leads to stenosis of the affected segment and dilatation of the bowel above this segment (up to megacolon congenitum). The first clinical sign is usually delayed meconium passage, in some children the first symptom is chronic obstipation


Miroslav Zeman, Zdeněk Krška, coll. Special surgery. 2014