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1059 Non-occlusive mesenteric ischaemia (NOMI) in neonates: a devastating disease

Archives of disease in childhood, 2021-10, Vol.106 (Suppl 1), p.A209-A210 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. ;2021 Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. ;ISSN: 0003-9888 ;EISSN: 1468-2044 ;DOI: 10.1136/archdischild-2021-rcpch.365

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  • Title:
    1059 Non-occlusive mesenteric ischaemia (NOMI) in neonates: a devastating disease
  • Author: Al-Anas Mat Ali, Adam ; Koo, Ho Wai ; Wong, Elaine
  • Subjects: Abdomen ; Abstracts ; Arteries ; Babies ; Blood vessels ; Distension ; Infants ; Intestine ; Ischemia ; Laparotomy ; Mortality ; Neonatal care ; Neonates ; Newborn babies ; Occlusion ; Ostomy ; Pediatrics ; Perfusion ; Stenosis ; Tetralogy of Fallot ; Transposition ; Trisomy ; Vasodilators
  • Is Part Of: Archives of disease in childhood, 2021-10, Vol.106 (Suppl 1), p.A209-A210
  • Description: BackgroundNOMI is an acute mesenteric circulatory disorder characterized by non-organic occlusion of blood vessels. It is an acute neonatal surgical emergency associated with high mortality.MethodsTo describe three cases of neonates with NOMI requiring laparotomy and surgical intervention.ResultsThree neonates with NOMI are described, all requiring laparotomy and bowel resection for extensive bowel ischaemia. Baby A was a 1900g 34 weeks infant with Trisomy 21, a large patent ductus arteriosus and duodenal stenosis which was surgically corrected on day 2. He developed abdominal distension on day 11 and underwent emergency laparotomy. Baby B was a 3600g term male infant with transposition of great arteries requiring an early balloon atrial septostomy with prostaglandin infusion while awaiting corrective surgery. He developed abdominal distension on day 11 and had extensive bowel ischaemia requiring resection. Both babies A and B developed multiple complications post-operatively and succumbed on day 38 and 66 respectively. Baby C was a 3200g term male infant with Tetralogy of Fallot and severe pulmonary stenosis requiring prostaglandin infusion. He developed abdominal distension on day 8 requiring surgical resection for extensive bowel ischaemia and stoma creation. The stoma was successfully closed following feeding establishment. He remains well at this time of writing.ConclusionsAlthough the mainstay of management in NOMI is reduction of spasm and improving perfusion of the mesenteric artery using vasodilators, the identification of at-risk neonates remains a challenge. In our case series, the NOMI had progressed extensively requiring laparotomy and bowel resection. The risk of mortality is high and a timely diagnostic laparotomy with excision of irreversibly necrotized intestine can be lifesaving.
  • Publisher: London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
  • Language: English
  • Identifier: ISSN: 0003-9888
    EISSN: 1468-2044
    DOI: 10.1136/archdischild-2021-rcpch.365
  • Source: Alma/SFX Local Collection
    ProQuest Central
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