Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2021; 9(22): 6557-6565
Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6557
Neonatal necrotizing enterocolitis caused by umbilical arterial catheter-associated abdominal aortic embolism: A case report
Xi Huang, Yan-Ling Hu, Yuan Zhao, Qiong Chen, Ying-Xin Li
Xi Huang, Yan-Ling Hu, Yuan Zhao, Qiong Chen, Ying-Xin Li, Department of Neonatal Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan Province, China
Xi Huang, Yan-Ling Hu, Yuan Zhao, Qiong Chen, Ying-Xin Li, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, Sichuan Province, China
Author contributions: Huang X contributed to the study design and data analysis and drafted the manuscript; Li YX contributed to the data analysis and critically revised the manuscript; Hu YL, Zhao Y, and Chen Q critically revised the manuscript; all authors read and approved the final manuscript.
Supported by the 2020 Scientific Research Project of the Sichuan Health and Family Planning Commission, No. 20PJ081.
Informed consent statement: The parents of the patient were informed about treatment-related risks and solutions. In addition, written informed consent was obtained from the patient’s parents for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying-Xin Li, MSN, Nurse, Department of Neonatal Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, No. 20 Section 3, Renmin South Road, Chengdu 610041, Sichuan Province, China. 632915584@qq.com
Received: April 12, 2021
Peer-review started: April 12, 2021
First decision: April 23, 2021
Revised: May 1, 2021
Accepted: May 15, 2021
Article in press: May 15, 2021
Published online: August 6, 2021
Processing time: 106 Days and 22.7 Hours
Abstract
BACKGROUND

Reports of necrotizing enterocolitis (NEC) caused by umbilical arterial catheter (UAC)-associated abdominal aortic embolism in neonates are rare. Herein, we report the case of an extremely low birth weight (ELBW) infant with NEC caused by UAC-associated abdominal aortic embolism.

CASE SUMMARY

A female infant, aged 21 min and weighing 830 g at 28+6 wk of gestational age, was referred to our hospital because of premature birth and shallow breathing. The patient was diagnosed with ELBW, neonatal respiratory distress syndrome, neonatal intrauterine infection, and neonatal asphyxia. Umbilical arterial and venous catheters were inserted on the day after birth and were removed 9 d later, according to the doctor’s plan. Within 48 h after extubation, the patient’s manifestations included poor responsiveness, heart rate range of 175-185/min, and currant jelly stool. Therefore, we considered a diagnosis of NEC. To determine the cause, we used B-mode ultrasound, which revealed a partial abdominal aortic embolism (2 cm × 0.3 cm) and abdominal effusion. The patient was treated with nil per os, gastrointestinal decompression, anti-infective therapy, blood transfusion, and low-molecular-weight heparin sodium q12h for anticoagulant therapy (from May 20 to June 1, the dosage of low-molecular-weight heparin sodium was adjusted according to the anti-Xa activity during treatment). On the 67th day after admission, the patient fully recovered and was discharged.

CONCLUSION

The abdominal aortic thrombosis in this patient was considered to be catheter related, which requires immediate treatment once diagnosed. The choice of treatment should be determined according to the location of the thrombus and the patient’s condition.

Keywords: Umbilical arterial catheter; Abdominal aortic thrombosis; Necrotizing enterocolitis; Neonate; Case report

Core Tip: We report a rare case of an extremely low birth weight infant with necrotizing enterocolitis (NEC) caused by umbilical arterial catheter-associated abdominal aortic embolism. Umbilical arterial and venous catheters were inserted on the day after birth and were removed 9 d later. Within 48 h after extubation, the patient’s manifestations were considered consistent with NEC. Color Doppler ultrasound showed partial thrombosis of the abdominal aorta (2 cm × 0.3 cm). She was treated with nil per os, gastrointestinal decompression, blood transfusion, anti-infective therapy, and low-molecular-weight heparin sodium q12h for anticoagulant therapy. On the 67th day after admission, the patient fully recovered and was discharged.