Time of First Defecation and Voiding in the Term and Premature Infants

PURPOSE: Almost of the term infants pass the first stool and urine within 48 hours after birth and delay of first defecation and voiding is considered as an initial sign of congenital intestinal obstruction or gastrointertinal motility disorder. In the premature infants, although they do not have congenital intestinal obstruction, the time of first defecation or voiding is delayed beacause of developmental prematurity of the gastrointestinal motility. To know factors which affect the time of first defecation and voiding, we studied. METHODS: From February 1993 to May 1995, Newborns (24 term, 77 premature, total 101) who were delivered in Soonchunhyang University Hospital without congenital intestinal obstruction were reviewed retrospectively about the relationship between the factors such as birth weight, gestational age, delivery type or the first feeding time and the first defecation or voiding time. RESULTS: 1) All of the term infants passed the first stool within 24 hours after birth. 2) Among the infants who passed the first stool after 24 hours since birth, 27.6% were 32-36 weeks and 40.5% were 27-31 weeks of gestational age. 3) Among the infants who passed the first stool after 24 hours since birth, 14.3% were 2,000-2,499gm, 35.7% were 1,500-1,999gm and 55% were 1,000-1,499gm of birth weight. 4) There was no statistically significant correlation between the first defecation time and sex, type of delivery or time of first feeding time. 5) Most of the term and premature infants passed the first urine within 24 hours after birth. There was no difference according to gestational age, birth weight, type of delivery or first feeding time. CONCLUSIONS: In larger parts of the premature and preterm infants, the first defecation wa delayed for 24 hours after birth. So, we should wait the first defecation more than 24 hours after birth in prematurity.

Time of First Defecation and Voiding in the Term and Premature Infants

PURPOSE: Almost of the term infants pass the first stool and urine within 48 hours after birth and delay of first defecation and voiding is considered as an initial sign of congenital intestinal obstruction or gastrointertinal motility disorder. In the premature infants, although they do not have congenital intestinal obstruction, the time of first defecation or voiding is delayed beacause of developmental prematurity of the gastrointestinal motility. To know factors which affect the time of first defecation and voiding, we studied. METHODS: From February 1993 to May 1995, Newborns (24 term, 77 premature, total 101) who were delivered in Soonchunhyang University Hospital without congenital intestinal obstruction were reviewed retrospectively about the relationship between the factors such as birth weight, gestational age, delivery type or the first feeding time and the first defecation or voiding time. RESULTS: 1) All of the term infants passed the first stool within 24 hours after birth. 2) Among the infants who passed the first stool after 24 hours since birth, 27.6% were 32-36 weeks and 40.5% were 27-31 weeks of gestational age. 3) Among the infants who passed the first stool after 24 hours since birth, 14.3% were 2,000-2,499gm, 35.7% were 1,500-1,999gm and 55% were 1,000-1,499gm of birth weight. 4) There was no statistically significant correlation between the first defecation time and sex, type of delivery or time of first feeding time. 5) Most of the term and premature infants passed the first urine within 24 hours after birth. There was no difference according to gestational age, birth weight, type of delivery or first feeding time. CONCLUSIONS: In larger parts of the premature and preterm infants, the first defecation wa delayed for 24 hours after birth. So, we should wait the first defecation more than 24 hours after birth in prematurity.

A Case of Castleman's Disease in Childhood

Castleman's disease(CD) is rare in childhood. It is defined as a localized nodal hyperplasia in mediastinum or cervical area. It is also called angiofollicular lymph node hyperplasia, lymph nodal hamartoma, giant lymph node hyperplasia. It was first described in 1956 by Castleman et al. as a lesion of mediastinal mass. The etiology of CD is not clear. The histologic classification of CD is hyaline vascular and plasma cell type. The hyaline-vascular type is more frequent, and characterized by small hyaline-folliclees and interfollicular capillary proliferation. The plasme cell type is characterized by the large follicles with intervening sheets of plasma cells. The clinical classification of CD is solitary and multicentric type. The solitary type is usually asymptomatic but, the multicentric type is usually combined systemic manifestations, such as fever, anemia, hyperglobulinemia. Complete surgical resection of involved lymph nodes is both diagnostic and therapeutic. The prognosis of solitary type is good, in a general way. We experienced CD cases in five-year-old girl, who had a 4x3 cm solid mass in postrior triangle of neck, right. The mass was removed completely and confirmed Castleman's disease microscopically. The histopathologic finding was a proliferation of germinal centers with hyaline thickening of the wall and the interfollicular stroma showed hyperplastic vessels admixed with lymphocytes, plasma cells and eosinophils. She discharged after six days of operation and her prognosis was good.