Idiopathic Perforation of the Stomach in the Newborn

Castleton, Kenneth B.

doi:10.1001/archsurg.1958.01280240032005

Cited by 24 publications

(6 citation statements)

References 28 publications

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“…In most adults, the cause of this condition is carcinoma or peptic ulcer, but the pathogenesis of gastric rupture in childhood is unknown (8). Regarding gastric rupture in neonates, there are different hypotheses, such as birth trauma (9), mechanical injury (10), idiopathic (11), congenital muscle defects (12), hypoxia (13) and increased intraluminal pressure (3,14). Our patient did not have a past history of birth trauma or hypoxia.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic gastric rupture in a 3‐month‐old girl

et al. 2003

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This case reports on idiopathic gastric rupture in a 3‐mo‐old girl who had frequent episodes of vomiting and abdominal distension the day before admission to the clinic. Metabolic acidosis was detected and rotavirus antigen was identified in the stools. Abdominal X‐rays and CT scans revealed free air and fluid in the abdominal cavity, leading to a diagnosis of gastrointestinal perforation. During surgery, idiopathic gastric rupture was detected and treated. The postoperative course was uneventful. Conclusion: Idiopathic gastric rupture is extremely rare in childhood beyond the neonatal period. Early diagnosis and surgery are mandatory if children with this condition are to be saved.

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Section: Discussionmentioning

confidence: 99%

Idiopathic gastric rupture in a 3‐month‐old girl

et al. 2003

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“…Spontaneous gastric rupture usually occurs in the first 5 days of life (often before 48 hr) (2). Approximately one-third of the infants are premature, males are affected 3-12 times as often as females, and Negroes more often than Caucasians (12,14).…”

Section: Materials and Methods Discussionmentioning

confidence: 99%

“…Our study was designed to investigate: ( 1 ) rupture although 1000 ml or more was injected and Pressures whether a healthy infant may have enough air in his stomach to exceeded 400 mm Hg (Table 4). Folloh-up radiographs and cause rupture and account for the large volume present after physical examination showed that the air escaped from the rupture and, (2) to test the theory that fluid within the stomach can stomach into the small bowel.…”

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confidence: 99%

Spontaneous Rupture of the Stomach in the Newborn: Clinical and Experimental Evaluation

et al. 1976

Pediatr Res

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Extractwhen the infants were taking formula orally, the gastrostomy tubes were vented to a large coll~cting balloon aboveeach patient (15). o u r study presents an experimental model for studying gastric ~h~ air swallowed into the stomach was readily measured with this rupture in the newborn. w e showed that gastric rupture could be system (Fig. I ). Because spontaneous rupture usually occurs when produced in eight newborn rodents and in three puppies less than 10 an infant is supine (6), these infants were fed in this position, which days old after injection of 120 ml air at 100 mm Hg pressure in the also prevented eructation. Initially, the infants were fed standard rodents and ml air at 240 inin Hg pressure in the puppies. formula, but after two gastrostomy tubes partially obstructed, Gastric rupture occurred with animals supine and with approxi-they were fed with sugar water only. Larger volumes of air were mately 20 ml barium injected into the stomach. Positioning of the collected from this latter group.animal in the supine position permitted the barium to pool in the To explore Hood's theory (6). that the antrum acts as a "fluid antral-pyloric region of the stomach.trap." the following experiment was performed. After intramuscular anesthesia. a thin nasogastric tube was placed in either rats', Speculation guinea pigs', or puppies' stomachs under fluoroscopic control.we believe that spontaneous gastric rupture occurs as a result o f a With the animal supine, either standard infant formula or an pooling of liquid barium or food in the pylorus equivalent volume of thin (25%) barium sulfate suspension (appermits a physio~ogic outlet obstruction of the stomach. our proximately 20 ml in each instance) was instilled into the stomach.observations indicate that normal infants accumulate considerable The animal was positioned SO that the liquid ~o o l e d in the amounts of air in the stomach while feeding. the stomach antral-pyloric region (as checked fluoroscopically in the animals distends reflux of air into the esophagus is impeded by an air-fluid given the barium suspension). A "Y" connector was placed in the trap at the esophageal-gastric junction. Thus, our study suggests proximal end of the nasogastric tube. o n e end of the Y connector that increased intraluminal pressure the stomach is sufficient Was joined with a 50-cc syringe. permitting increments of air to be to cause gastric rupture in the newborn and that the fluidmair trap is introduced; the other end was connected to a gauge that measured an important mechaism in gastric rupture. pressure after each injection (Fig. 2). Eight rodents (five rats and three guinea pigs) and six puppies were used for this study. After this procedure the animals were Spontaneous rupture of the stomach characteristically occurs in autopsied and the stomachs examined. the first days of life as a linear tear high on the stomach wall. Since the original description by Siebold in 1825. there has been a great RESULTS

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“…Las primeras publicaciones sobre este problema aparecieron en 1925 y 1928 2 , oportunidad en que se intento por primera vez el tratamiento quirurgico, asumiendose que el cuadro equivah'a a una iilcera gastrica del adulto. En 1943 se informo sobre una deficiencia congenita de la pared gastrica y solo en 1950 se logro la primera operacion exitosa, atribuyendose la causa de la perforacion a una deficiencia de la pared gastrica 3 . De 44 casos de PG, 22 correspondian a perforaciones de la curvatura mayor y 4 cerca de la menor.…”

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Perforación gástrica en el recién nacido

M²

1988

Rev. chil. pediatr.

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Gastric perforation ocurred in the second day of life in an apparently healthy newborn of 36 weeks gcstational age and was succesfully repaired, but recurred eight days later. At the second surgical intervention a previously inadverted intestinal mairotation was detected and corrected obtaining normal intestinal transit. At 60 days of life he was submited to surgical intervention for intestinal obstruction caused by peritoneal adhesions without evidence of perforation. The patient died later from secondary peritonitis, that was confirmed at authopsy. Gastrointestinal perforations were not found in this later examination. (

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Idiopathic Perforation of the Stomach in the Newborn

Cited by 24 publications

References 28 publications

Idiopathic gastric rupture in a 3‐month‐old girl

Idiopathic gastric rupture in a 3‐month‐old girl

Spontaneous Rupture of the Stomach in the Newborn: Clinical and Experimental Evaluation

Perforación gástrica en el recién nacido

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