Umbilical cord ulcer: a serious in utero complication of intestinal atresia.
Umbilical cord ulcer: a serious in utero complication of intestinal atresia.
复制标题
脐带溃疡：肠闭锁的严重宫内并发症。
DOI：
10.1053/plac.1999.0480
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发表时间：
2000
期刊：
影响因子：
3.8
通讯作者：
Y. Tanaka
中科院分区：
文献类型：
--
作者：
M. Ohyama;Y. Itani;M. Yamanaka;K. Imaizumi;T. Nishi;R. Ijiri;Y. Tanaka
我们已经经历了六例脐带溃疡，导致危及生命的产前胎儿出血。胎儿窘迫和羊水血性导致宫内和新生儿死亡4例患者妊娠过程复杂化。剩下的两名婴儿仍然活着。所有婴儿均出现乳头以下上肠闭锁。病理上，所有病例的脐动脉和周围的华顿氏果冻都坏死。含有色素颗粒的活化巨噬细胞存在于溃疡床、沃顿氏果冻坏死区域和胎膜内。同期我们还发现了38例上肠闭锁，其中23例检查了胎盘。在23例病例中有3例可见沃顿氏果冻的显微镜变性。1例脐带溃疡患者羊水中总胆汁酸含量升高。我们推测脐带溃疡与子宫内胆汁反流密切相关。我们还认为，这种严重关联的发生率比以前报道的要高。
We have experienced six cases of umbilical cord ulcer that resulted in life-threatening antenatal fetal haemorrhage. Fetal distress and bloody amniotic fluid that led to intrauterine and neonatal death in four patients complicated the pregnancy courses. The remaining two infants are still alive. All the infants had upper intestinal atresia below the papilla of Vater. Pathologically, umbilical arteries and surrounding Wharton's jelly were necrotic in all cases. Activated macrophages containing pigment granules were present within the ulcer bed, necrotic areas of Wharton's jelly and fetal membranes. During the same period, we encountered 38 other cases of upper intestinal atresia and the placentae were examined in 23 cases. Microscopic degeneration of Wharton's jelly was seen in three out of 23 cases. Total bile acids content in amniotic fluid was elevated in one case of umbilical cord ulcer. We speculate that the umbilical cord ulcer is closely related to in utero regurgitation of the bile. We also think that the incidence of this serious association is higher than has been reported previously.