Introduction: Intestinal obstruction is a common cause of
abdominal surgery in the neonate. Diagnosis
is straightforward using standard radiology, and surgical technique depends on the underlying
anatomical lesion. Peritoneal dialysis (PD) is an effective, albeit
invasive, therapy for neonatal renal failure. We report a case of neonatal
obstruction with severe renal failure treated by PD to highlight our hospital
practice and possible remedies in a context of limited resources. Case Presentation:
This was a female neonate of moderate prematurity
admitted on day 4 of life for management of a flat neonatal obstruction. Radiological diagnosis suggested small
bowel atresia. Biological tests revealed severe renal failure with
creatinine levels of 416 micromoles per liter and blood urea of 27.1 micromoles
per liter. Management consisted of preoperative peritoneal dialysis for 48
hours followed by laparotomy. The intraoperative diagnosis was GROSFELD type
IIIa digestive atresia. The postoperative course was favourable, transit was
resumed on day 5 and the patient returned home on day 12. Progress at 3 months
was satisfactory. Conclusion: Neonatal intestinal obstruction with renal
failure in premature infants is associated with a poor prognosis, even more so
if there is a delay in treatment. Peritoneal dialysis seems to be a suitable
alternative for this management in our working conditions with limited
resources.
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