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Saddle Embolus Occluding Pulmonary Arteries

Am J Dis Child. 1978;132(9):926. doi:10.1001/archpedi.1978.02120340102021.
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Parenteral alimentation is invaluable in salvaging infants who otherwise would have been unable to survive congenital anomalies of the intestine or necrotizing enterocolitis.1

A catastrophe complicated an infant's recovery from bowel resection and intolerance to oral feeding.

Report of a Case.—A 14-day-old, full-term baby girl was referred with bloody stools and abdominal distention; roentgenograms demonstrated pneumatosis intestinalis and air in the portal venous system. Nine centimeters of necrotic ileum, cecum, and ascending colon were removed, and total parenteral nutrition given via superior vena caval catheters placed first in each external jugular vein and finally in the left internal jugular vein. Her nutritional status greatly improved, but even 5% glucose per ostium was intolerable. At 2 months of age, pallor and orthopnea with slow gasping respirations suddenly developed; she died half an hour later. Clinical impression was pulmonary embolus.

Autopsy showed a small, fairly wellnourished infant weighing 3,490 g,


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