We present a case of tubular esophageal duplication in a 3-day-old female newborn (38 weeks, 2,500 g) without concomitant abnormal development. Esophageal duplication was diagnosed based on the clinical picture, direct laryngoscopy, esophagography and computed tomography. The duplicated esophagus was resected by thoracoscopy leaving the orthotopic esophagus in place. Isolation from the pharynx was performed via a separate cervical incision. After a follow-up period of 20 months, the child returned to normal growth and development.
The analysis of the balance of elastase (MMP-2, MMP-9) and TIMP-4 was performed in order to determine its involvement in the pathogenesis of NEC. A progressive duration of NEC with sepsis is accompanied by increased serum concentrations of MMP-9, MMP-2 and TIMP-4. Increases in concentrations of MMP-2>503 ng/ml, MMP-9>812 ng/ml TIMP-4>1404 ng/ml can be regarded as statistically significant predictors of fatal outcome of NEC. The proposed method for determination of the outcomes of NEC in newborns is characterized by high sensitivity (94%) and specificity (87%).
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