PMC8110704_01
PMC8110704_02
The appearance of the distal ileum at the time of original surgery. At the time SID was not identified. A band (B) attached to a Meckel Diverticulum can be seen. The proximal (P) and distal (D) caliber change is noted.
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F1
On day 27 of life the child presented to the emergency department with distended abdomen, and an emergency exploratory surgery to rule out adhesions was done, and a band was found across the ileum close to the ileocaecal valve, Figure 1.
PMC8110704_03
(A) MRI brain T2 weighted image that highlight cerebral oedema and cortical sulcal effacement. (B,C) Diffusion weighted image of the brain showing extensive areas of increased signal intensity with corresponding low ADC value, suggestive of hypoxic/ischemic brain injury.
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F2
With pediatric neurology input, the patient underwent an MRI brain which was reported to be consistent with diffuse cerebral edema, and extensive areas of restricted diffusion, Figure 2.
Twelve lead ECG showed sinus regular rhythm with Long QTC [QT = 0.52 s, QTC = 520. Prolonged] (arrows).
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F3
She was started on propranolol 1 mg/kg/day (Figure 3).
PMC8110704_04
(A) Fixed loops of the dilated segments of ileum that became apparent within 24 h following ileostomy closure (B).
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F4
On the 3rd day post op she developed severe abdominal distension with markedly distended bowel loops that were fixed on serial x-rays (Figure 4).