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Abstract: A parent came to the clinic with a child who was born only 2 weeks ago, saying that the child had recurrent vomiting today, vomiting every time he ate milk, and basically he could not feed himself and vomited a large amount of milk. After careful examination, we found that the child’s bowel sounds were diminished, the abdomen was distended, and the abdominal wall was in high tension. He was given fasting and gastrointestinal decompression, and his condition improved, and he did not vomit again.
Basic information】Female, 2 weeks
Disease Type】Neonatal intestinal obstruction
Hospital】Shanghai Sixth People’s Hospital
Date of Consultation】February 2021
Treatment plan] Cardiac monitoring + fasting + gastrointestinal decompression (enema) + medication (vitamin C injection)
[Treatment period] Discharged after 1 week of hospitalization, followed by outpatient visit 3 days later
Treatment effect】No more vomiting, resumed feeding, and satisfactory increase in milk quantity
I. Initial consultation
One night, a parent came to the hospital with her 2-week-old child in her arms, saying that the child had suddenly vomited 8 times today, every time after drinking milk. The parents said that the child was not in a good condition after coming home because he might have gotten cold when he went out yesterday. The child underwent a detailed physical examination, and there was no abnormality in cardiopulmonary auscultation, abdominal distension, increased abdominal wall tension, and decreased intestinal sounds on auscultation, followed by abdominal standing X-ray examination, and intestinal obstruction was found.
II. Treatment process
After the child was admitted to the hospital, the relevant tests were completed, and the indicators such as blood routine, liver and kidney function, electrolytes and cardiac enzyme spectrum were basically normal. He was given cardiac monitoring, close care, intravenous infusion of vitamin C injection, fasting for gastrointestinal decompression, and contacted surgery for enema operation. After 1 week of active treatment and meticulous care, the child was initially fed by nasogastric tube and then gradually transitioned to oral feeding, and all of them ate smoothly without vomiting. When the child’s abdomen was reviewed on standing radiographs, there was no longer any obvious manifestation of intestinal obstruction.
III. Treatment effect
After 1 week of inpatient treatment, the child no longer vomited, had good willingness to eat milk, was able to complete the amount of milk intake required at the next month of age, had good sleep quality, did not cry or scream abnormally, had normal bowel movements, had good mental status, and could interact well with parents. The child was discharged and the parents were asked to bring the child to the outpatient clinic for re-examination in 3 days, and the parents indicated that the symptoms of intestinal obstruction did not recur and the child’s mental condition and appetite were back to normal.
IV. Notes
We are glad that the child recovered after 1 week of treatment and care and no more vomiting. However, since the gastrointestinal function of newborns is not yet perfect, parents should pay attention to scientific feeding of the baby, avoid getting cold, avoid dry stools, burp the baby after feeding, and rub the belly when there is slight abdominal distension. Observe the child’s milk consumption and bowel movements. If the child eats less milk, does not want to eat milk, or stops having bowel movements, you must pay attention to the situation and take the child to the hospital in time.
V. Personal insight
Spitting up and overflowing is also common in newborns, but it usually does not happen too many times a day and may only spill a little when eating more. If you find frequent and violent vomiting and cannot drink milk at all, you need to be alert to neonatal intestinal obstruction, especially if defecation is usually frequent and suddenly stops one day, you must pay attention to it and take the child to the hospital in time to investigate the cause, so as not to handle it in time and lead to necrotizing enterocolitis, intestinal perforation or even peritonitis and other critical situations, which not only bring pain to the child, but also The child’s life is also at risk. After treatment, the child’s symptoms have been significantly relieved, but parents are advised to observe the child’s condition and follow up promptly if the symptoms reappear.