Double Intussusceptions with Necrotizing Enterocolitis Diagnosed in a Premature Infant

Intussusception in neonates, especially in preterm infants, is rare. Common symptoms of intussusception, which include distended abdomen and gastric residuals, lead to misdiagnosis as necrotizing enterocolitis (NEC). Delayed diagnosis of neonatal intussusception delays treatment as well, which can lead to life-threatening complications. The predominant location of intussusception in preterm neonates is the small bowel; therefore, ultrasonography is not indicated. We report the case of an 834g male baby born at 25 weeks 6 days of gestation, who was diagnosed with double intussusceptions with NEC.

Evaluation of Clinical Factors Associated with Early Tracheal Extubation after Liver Transplantation / 대한마취과학회지

BACKGROUND: The timing of tracheal extubation in patients undergoing major intraoperative procedures is controversial. Immediate postoperative tracheal extubation after liver transplantation was not popularized. But in these days, early tracheal extubation has been safely performed in certain cases and routine use of mechanical ventilation is being questioned. We performed preliminary study of our 25 liver transplantation cases to evaluate factors affecting duration and indications of postoperative mechanical ventilation. METHODS: Our 25 cases were divided into two groups by periodic difference - early 13 cases (group 1) and late 12 cases (group 2). We evaluated preoperative UNOS (united network for organ sharing) scale, intraoperative transfusion and vasopressor requirement, postoperative multiple organ complications which would have influence upon tracheal extubation. RESULTS: We found great difference between two groups in duration of mechanical ventilation (Group 1: 94.4+/-7.12 hrs, Group 2: 36.1+/-28.3 hrs) and ICU stay (Group 1: 22.8+/-8.3 days, Group 2: 11.8+/-5.5 days). CONCLUSIONS: We concluded that early tracheal extubation in selected liver transplantation cases was safe and effective because it could shorten duration of ICU stay and reduce postoperative mortality. But more experience and knowledge may be needed to get more ideal guidelines for postoperative mechanical ventilation.