Diagnosis and treatment of postoperative intestinal perforation in infants and young children with congenital heart disease: A report of three cases

Abstract

Abstract. The aim of the present study was to analyze risk factors of intestinal perforation following surgery for the treatment of congenital heart disease in infants and young children, and to summarize experiences of diagnosis and treatment. A total of 3,270 children, who underwent congenital heart disease surgery under extracorporeal circulation from January 2010 to July 2015, were retrospectively analyzed. Among these children, three (0.09%) developed postoperative intestinal perforation. Primary diseases were Tetralogy of Fallot (two cases) and ventricular septal defect combined with atrial septal defect (one case). The age range of the children was 6-11 months and the weight range was 7.3-8.6 kg. Furthermore, these children underwent radical surgery under general anesthesia and extracorporeal circulation in low temperatures. Abdominal symptoms appeared 4-10 days after surgery, and included poor appetite, abdominal distension, intermittent vomiting, high fever, refractory irritability, crying and shortness of breath. One case was confirmed by routine abdominal puncture and the remaining two were confirmed by the detection of free gas under the diaphragm, as revealed by abdominal X-ray. Following the diagnosis of intestinal perforation, emergency intestinal fistula surgery was performed. At 3-5 days post-surgery, the patients underwent treatment by fasting and intravenously administered parenteral nutrition.

Ameliorative effects of the mixed aqueous extract of Aurantii Fructus Immaturus and Magnoliae Officinalis Cortex on loperamide-induced STC mice

“…The pathophysiological mechanisms of STC are complex and involve numerous factors, including defects or dysfunction of the central nervous system and enteric nervous system, aberrant secretion of neurotransmitters and GI hormones, aberrant expression of AQPs in the intestinal epithelium, reduction and dysfunction of ICCs, and alterations in the gut microbiota and associated metabolites [ 35 ] Chinese herbal medicine has been used to treat constipation for thousands of years in China. Two of the most commonly prescribed medications for constipation, AFI and MOC, have been documented in numerous classic prescriptions [ 13 , 14 ]. In our study, the administration of a mixed aqueous extract of AFI and MOC resulted in a significant increase in faecal water content and intestinal propulsion rate in STC mice.…”

“…Honokiol also has minimal toxicity; intravenous administration of honokiol showed a rapid rate of distribution and absorption with slower elimination [ 12 ]. The mixed aqueous extract of AFI and MOC has been used to treat defaecation problems in China for more than 2000 years and is now widely used as an important ingredient in TCM prescriptions for constipation treatment [ 13 , 14 ]. In light of the TCM theory and the findings presented above, therapeutic effects of AFI and MOC on STC can be expected.…”

Identifying the active compounds and mechanism of action of TongFu XieXia Decoction for treating intestinal obstruction using network pharmacology combined with ultra‐high performance liquid chromatography‐quadrupole‐orbitrap mass spectrometry

“…Nevertheless, the effectiveness of conventional therapies varies, occasionally falling short of desired outcomes. The limited array of treatment options contributes to the prolonged state of IO, potentially exacerbating patients' conditions and resulting in malnutrition, electrolyte imbalances, septic shock, intestinal ischemic necrosis, and other adverse consequences 6 . In summary, there is an urgent need for the development and implementation of safe, effective, and low‐toxicity pharmaceuticals for IO treatment.…”