morphine and Urinary-Fistula

Enterolithiasis is an uncommon finding of intraluminal calcified meconium. Whereas extraluminal calcifications are commonly reported and usually indicate intrauterine intestinal perforation with intraperitoneal extravasation of meconium (meconium peritonitis), true intraluminal calcifications of meconium in newborns are rare.. We report a case of a newborn boy with pneumothorax and pneumoperitoneum because of a transmediastinal air leakage who unfortunately died on the fifth postnatal day after a pneumopericard. The baby had lung hypoplasia and a hypoplastic thorax. Oligohydramnion was present because of urethral agenesis and anal atresia with rectourinary fistula. Enterolithiasis was found, distributed from the transverse to the rectosigmoid colon. Enterolithiasis was not diagnosed prenatally in this boy, and any of those preexisting pathologies were therefore not assumed before birth except the suspicion for urethral valves because of oligohydramnion.. Approximately 48 cases of human neonatal enterolithiasis have been described in the medical literature. The etiology of enterolithiasis appears to be intraluminal mixture of meconium und alkaline urine--as it appears in anal atresia with enterourinary fistula. Most cases of enterolithiasis are associated with major urogenital and intestinal malformations--especially VACTERL association. With support of modern high-resolution imaging devices, enterolithiasis can be detected antenatally. We suppose that prenatal diagnosis of enterolithiasis is a warning sign of underlying pathologies.

Topics: Abnormalities, Multiple; Colonic Diseases; Critical Illness; Fatal Outcome; Humans; Hydronephrosis; Infant, Newborn; Infant, Premature; Lithiasis; Male; Meconium; Pneumoperitoneum; Pneumothorax; Rectal Fistula; Urinary Fistula

Intraintestinal meconium calcification in the fetus and newborn is a rare finding, occurring in patients with intestinal obstruction. The intraluminal location of the enterolithiasis enables differentiation from calcifications that are secondary to bowel perforation and meconium peritonitis. We report on a term male neonate with VACTERL (vertebral defects, imperforate anus, cardiac anomalies, tracheoesophageal fistula, renal anomalies, limb anomalies) association and rectourethral fistula, in whom enterolithiasis was documented by prenatal ultrasound imaging at 21 weeks' gestation. A review of the literature and a summary of all previously described cases of neonates with intraluminal meconium calcifications are provided. Prenatal ultrasonographic detection of enterolithiasis in fetuses with anal atresia may indicate the presence of an enterourinary fistula.

Topics: Adult; Anus, Imperforate; Calcinosis; Colonic Diseases; Female; Humans; Infant, Newborn; Male; Meconium; Pregnancy; Rectal Fistula; Ultrasonography, Prenatal; Urethral Diseases; Urinary Fistula

A 2-day-old girl with an urethrorectal fistula as part of an anorectal septum malformation showed intra-abdominal densities in the colon on radiologic examination, due to calcified meconium balls. This calcification is caused by the presence of urine in the intestinal tract and therefore confirms the presence of an urethrorectal fistula.

Topics: Calcinosis; Diagnosis, Differential; Female; Humans; Infant, Newborn; Meconium; Radiography, Abdominal; Rectal Fistula; Urinary Fistula

Calcified intraluminal meconium is a rare finding in newborn infants. It is often associated with communication between the urinary and gastrointestinal tracts. Intra-abdominal calcifications are unusual radiographic findings in the newborn and can easily be misinterpreted as meconium peritonitis. We report on a newborn infant with anorectal malformation, meconium balls, intraluminal calcifications, colpocephaly, and agenesis of the corpus callosum, a rare association.

Topics: Agenesis of Corpus Callosum; Anus, Imperforate; Calcinosis; Humans; Infant, Newborn; Male; Meconium; Nervous System Malformations; Rectal Fistula; Urinary Fistula

Extraluminal calcified meconium is found frequently by prenatal ultrasound in cases with bowel perforation and meconium peritonitis. Intraluminal intestinal meconium calcifications are rarely seen in prenatal sonography. Meconium calcifications result from a mixture of meconium and urine that indicates a connection between intestinal and urinary tract. We report a case of a male newborn prenatally diagnosed with intraluminal echogenic calcifications at 23 weeks of gestation, suggesting an anorectal malformation (ARM) with rectourinary fistula. At birth, the child presented with a complex ARM including high anal atresia with both perineal and rectourethral fistula. Furthermore, a bladder outlet obstruction due to a urethral stenosis was diagnosed. Vesicostomy was performed as an emergency procedure followed by colostomy during neonatal period. Posterior sagittal anorectoplasty was performed at the age of 4 months. Prenatal echogenic calcifications within bowel should raise the suspicion of ARM with rectourinary fistula and bladder outlet obstruction.

Topics: Abnormalities, Multiple; Anal Canal; Calcinosis; Colostomy; Humans; Infant, Newborn; Male; Meconium; Rectal Fistula; Rectum; Ultrasonography, Prenatal; Urinary Bladder Neck Obstruction; Urinary Fistula

Intraluminal meconium calculi are a rare cause of neonatal abdominal calcifications in patients with anorectal malformations. To investigate their pathogenesis, we performed infrared spectroscopic analysis of meconium-calcified lesions.. Meconium calculi were collected from the colostomy in a newborn patient with imperforate anus and rectourethral fistula. The potassium bromide method was employed to obtain the infrared absorption spectrum of the meconium calculi.. The wavelength pattern of the meconium calculi exhibited 4 specific peaks at 1570, 1390, 1105, and 1005 cm(-1) between 22% and 45% transmittance values. The unique absorption spectrum exclusively indicated ammonium hydrogen urate (C(5)N(5)O(3)H(7)), having the combined constituents of ammonium and uric acid.. These results suggest that the intraluminal meconium calculi were originally derived from meconium and fetal urine. The stasis of meconium passage and fetal urine mixing through the rectourethral fistula in a low-pH condition was deduced to be the main cause of this rare stone formation.

Topics: Anus, Imperforate; Calculi; Colon; Colonic Diseases; Humans; Infant, Newborn; Male; Meconium; Radiography; Rectal Fistula; Spectrophotometry, Infrared; Urethral Diseases; Urinary Fistula

Calcified intraluminal meconium is rarely observed in newborn. Only 27 cases are related in litterature; the authors report 4 new cases and point out the role of intestinal obstruction (principaly anorectal malformations, but also atresia, meconium ileus or Hirschsprung disease). Pathogenesis is unknown, while intestinal urinary fistula is frequently described.

Topics: Abnormalities, Multiple; Calcinosis; Digestive System Abnormalities; Humans; Infant, Newborn; Intestinal Fistula; Intestinal Obstruction; Male; Meconium; Urinary Fistula; Urinary Tract

Five cases are reported and reference is made to 3 previous similar cases of calcified intraluminal meconium in newborn males with "imperforate anus." A rectourinary fistula was found in most of the patients; none of the cases had meconium peritonitis. The calcifications may develop in areas of prolonged stasis; the possible added role of the mixture of urine and meconium in utero is raised.

Topics: Abnormalities, Multiple; Anus, Imperforate; Calculi; Humans; Infant, Newborn; Intestinal Diseases; Male; Meconium; Radiography; Rectal Fistula; Urinary Fistula