1968
DOI: 10.1136/bmj.4.5627.349
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Perforation of the Bowel in the Newborn as a Complication of Exchange Transfusion

Abstract: Colonic Perforation after in that in the resected specimen in Case 3 there were numerous red patches on the antimesenteric border of the descending colon. These were acutely congested patches that had not actually infarcted, and in Case 4 similar patches in the sigmoid colon actually showed full-thickness necrosis which had not perforated, presumably because of the proximal perforation. Why these lesions should be more common in the colon than in the small bowel is difficult to explain if the condition is due… Show more

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Cited by 62 publications
(5 citation statements)
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“…Abdominal distension was observed by Farquhar and Smith (1958) in 3 babies after exchange transfusion. Perforation of the colon after this procedure has been reported by Corkery et al (1968) and by Orme and Eades (1968), who also described this complication in a baby given dextrose by umbilical vein catheter for 7 days. Toxic substances which can be leached out of PVC tubing by infused solutions have been shown by Duke and Vane (1968) to affect the normal response of the perfused human umbilical artery to stimuli, and by Bowery and Lewis (1968) to cause contraction of the isolated guinea-pig ileum; the effect on the portal vasculature of these substances and of a 10% solution of dextrose, which has a pH of 5 * 6 or less and is irritant, might explain the transient obstruction of 5 infants in this series.…”
Section: Discussionmentioning
confidence: 70%
“…Abdominal distension was observed by Farquhar and Smith (1958) in 3 babies after exchange transfusion. Perforation of the colon after this procedure has been reported by Corkery et al (1968) and by Orme and Eades (1968), who also described this complication in a baby given dextrose by umbilical vein catheter for 7 days. Toxic substances which can be leached out of PVC tubing by infused solutions have been shown by Duke and Vane (1968) to affect the normal response of the perfused human umbilical artery to stimuli, and by Bowery and Lewis (1968) to cause contraction of the isolated guinea-pig ileum; the effect on the portal vasculature of these substances and of a 10% solution of dextrose, which has a pH of 5 * 6 or less and is irritant, might explain the transient obstruction of 5 infants in this series.…”
Section: Discussionmentioning
confidence: 70%
“…Delayed complications may occur. Both colonic perforations (Orme and Eades, 1968;Friedman et al, 1970: Sommerschild, 1971) and necrotizing enterocolitis following exchange transfusions have been attributed to a decreased ileal and colonic blood flow during the procedure (Touloukian et al, 1973). These effects may be minimized by slow rate of transfusion manually by a syringe and/or by the use of a drip-method (Valaes, 1966) which allows slow infusion of blood.…”
Section: Discussionmentioning
confidence: 99%
“…The onset is earlier and more rapid than in preterm infants and predisposing disorders affecting the circulation are usually present. NEC in term infants has been linked to congenital heart disease and/or heart operation [48,49] , perinatal asphyxia, polycythemia [50] , exchange transfusion [51][52][53][54] , protracted diarrhea with dehydration, maternal cocaine abuse, and exposure to HIV or antiretroviral medication.…”
Section: Related Disorders and Differential Diagnosismentioning
confidence: 99%