Delayed Burst Abdomen in a Neonate

Excerpt

To the Editor: A 29⁺² wk preemie delivered to a G₂P₁ mother out of non-consanguineous marriage, needed intubation and surfactant at birth. In the NICU, she was extubated to nasal continuous positive airway pressure but subsequently required re-intubations following Bacillus circulans sepsis. She developed recurrent feed intolerance, despite treating sepsis. X-rays of abdomen, upper and lower gastrointestinal dye study were inconclusive. Exploratory laprotomy on day 64 showed healthy bowels and normal intestinal biopsy. Post-operatively, baby continued to be ventilated and needed steroids to faciliatate extubation. After 35 d of laparotomy, baby had scar dehisence with evisceration of large segment of bowel loops, necessitating secondary closure. Following this rare catastrophic event, clinical history was reviewed. Central core disease (CCD) involving RYR1 mutation was traced in mother and elder male sibling. Genomic sample of the baby was heterozygous for the same mutation. After 8 mo of NICU stay, baby was discharged with tracheostomy in situ. …