Neonatal Gastric Perforations: Are They Really Spontaneous?

Gupta, Gaurav; Kumar, Sachin; Gupta, Shubham; Golhar, K. B.; Deshpande, Swapnil

doi:10.1007/s12262-013-0980-7

Cited by 11 publications

(10 citation statements)

References 7 publications

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“…The 32-week premature infant was born with 1,200 gm and was seen on the third day with abdominal distension, erythematous skin, and an X-ray confirmed the presence of pneumoperitoneum. The laparotomy evidenced the presence of great gastric perforation along the great curvature and pyloric diaphragm Gupta draws attention to the prevalence of premature and low birth weight, but it can also occur in term children, as is our case [13]. Dickens reported the incidence of neonatal gastric perforation as 34/1000 live births, being more frequent in men (4X), aged between the 4 th and 7 th day [14].…”

Section: Discussionsupporting

confidence: 53%

Gastric Perforation: Postmortem Diagnosis

Mes¹

2018

Journal of Forensic and Crime Studies

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Journal of Forensic and Crime StudiesGastric perforation, in neonates, is a rare complication, but with high morbidity. Generally, the diagnosis is made, in vivo, in premature, low-weight children, with or without several risk factors, such as the use of mechanical ventilation, gastric tube placement, and gastrointestinal abnormalities, such as esophageal atresia, duodenal membranes, poor rotation intestinal necrotizing enterocolitis. There is no consensus as to how idiopathic forms of gastric perforation are also adventurous histologically in the musculature of the gastric wall. We presented a surveillance case, which was referred to the IML-DF for cadaveric examination, with suspicion of sudden death. During the examination, generalized peritonitis and perforation of great curvature of the stomach were identified, without other gastrointestinal activities.

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Section: Discussionsupporting

confidence: 53%

Gastric Perforation: Postmortem Diagnosis

Mes¹

2018

Journal of Forensic and Crime Studies

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“…Gastric necrosis and perforation are rare conditions in neonates, as among more than 84 000 live births only 7 cases were identified [ 5 ]. Gastric perforation is more common in preterm neonates and most commonly occurs from the 2 nd to the 7 th days [ 6 ]. The patient presented in this case report was premature and the perforation occurred on the 4 th day of life.…”

Section: Discussionmentioning

confidence: 99%

Neonatal Gastric Necrosis and Perforation Treated by Subtotal Gastrectomy and Esogastric Anastomosis: A Case Report

Khemakhem¹,

Mahdi²,

Algethami

et al. 2021

Am J Case Rep

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Patient: Male, 4-day-old Final Diagnosis: Gastric perforation and necrosis Symptoms: Acute abdominal distension • metabolic acidosis • respiratory distress Medication: — Clinical Procedure: — Specialty: Pediatrics and Neonatology • Surgery Objective: Congenital defects/diseases Background: Gastric necrosis and perforation are rare life-threatening conditions in preterm neonates, which require urgent diagnosis and surgical intervention. Case Report: We report a case of a 4-day-old patient with neonatal gastric necrosis. The patient presented with sudden acute abdominal distension, respiratory distress, and metabolic acidosis. The abdomen was markedly distended, tender, and tympanic with collateral circulation. An X-ray of the abdomen showed a huge pneumoperitoneum. An urgent exploratory laparotomy revealed 2 wide horizontal perforations and necrosis of the fundus and gastric body. Subtotal gastrectomy with esogastric anastomosis was done. Postoperatively, the patient was administered total parenteral nutrition and triple antibiotics and improved gradually. He passed stool and the abdomen was soft, lax, and non-distended and the wound healed. An upper gastrointestinal tract (UGIT) contrast study 1 week after the operation showed no leakage or stricture. The patient was discharged 2 months postoperatively with a bodyweight of 2 kg and was followed in the Outpatient Department (OPD). The patient survived after 80% gastric resection for necrosis of the stomach, which was a unique outcome for this major surgery. Conclusions: Gastric perforation is a rare life-threatening condition in preterm neonates, usually managed by direct closure in layers. Exceptionally, partial gastrectomy is needed, which is a major operation, with a high mortality rate and poor outcome. We present a case of a preterm neonate who survived after 80% gastric resection for stomach necrosis.

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“…16,17 Vigorous supportive measures, intravenous infusions, antibiotics, nasogastric suction, and vasoactive support are mandatory. 18 Rarely, partial gastrectomy or subtotal gastrectomy is indicated. 17,19 The major indication of sleeve gastrectomy is for bariatric interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Although spontaneous healing of gastric perforation has been observed in neonates after conservative management, urgent surgical repair of the perforation with debridement of the edges and primary closure of the perforation in two layers is the treatment of choice 16,17 . Vigorous supportive measures, intravenous infusions, antibiotics, nasogastric suction, and vasoactive support are mandatory 18 …”

Section: Discussionmentioning

confidence: 99%