Severe Pulmonary Valve Stenosis in a Neonate with Necrotizing Enterocolitis: a case report

Abstract Background Patients with congenital heart disease are predisposed to neonatal necrotizing enterocolitis, especially in very low and extremely low birth weight infants. It has never been reported about the perioperative management. Case presentation We describe the first reported case of severe pulmonary valve stenosis with neonatal necrotizing enterocolitis IIIB in an infant who successively underwent exploration of the heart and laparotomy. The infant was ultimately discharged with good improvement after treatment with linezolid anti-infective, enoxaparin anticoagulant, and organ support. In the present case, pathogenic bacteria were identified using metagenomic next-generation sequencing-guided antibiotic replacement, highlighting its usefulness in children with peritonitis complicated by ascites. The neonatal right atrial thrombus was treated with timely and regulated anticoagulation after thrombolysis and did not develop into a pulmonary embolism. Conclusions It was a reference for the perioperative management and treatment of congenital heart disease-necrotizing enterocolitis. Utilizing metagenomic next-generation sequencing for the detection of pathogenic organisms and examining four items of thrombosis levels should be promoted for the care of patients with severe pulmonary valve stenosis with necrotizing enterocolitis.