Pediatric gastric perforation beyond neonatal period: 8-year experience with 20 patients

Wang, Kai; Cai, Siyu; He, Lejian; Peng, Chunhui; Pang, Wenbo; Wang, Zengmeng; Wu, Dongyang; Chen, Yajun

doi:10.1016/j.pedneo.2019.03.006

Cited by 6 publications

(6 citation statements)

References 26 publications

(18 reference statements)

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“…13 The majority of neonatal and paediatric gastric perforations are found on the greater curvature. 14,15 This can be explained by gastric receptive relaxation theory. The greater curvature is the most distensible area of the gastric wall and is prone to ischemic necrosis and resultant perforation.…”

Section: Discussionmentioning

confidence: 99%

Extensive gastric necrosis in an infant

et al. 2021

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Gastric necrosis is a rare condition, more so in children and can be potentially fatal. The sloughing of the necrosed wall results in perforations or large defects in the gastric wall. We report a rare case of extensive gastric necrosis in a 2 months old female infant, managed successfully. Child presented with non-bilious vomiting and excessive cry. There was history of recurrent upper abdominal distension. X-ray of abdomen showed massive pneumoperitoneum. Intra operatively, posterior gastric wall was sloughed off and lower end of feeding tube was lying in the peritoneal cavity. Necrotic wall was debrided and stomach tube was created from remaining anterior gastric wall. Gastrostomy and jejunostomy was done. Post-operative period was uneventful. Dye study at three months showed good gastric capacity. Stomach being a well vascularised organ, necrosis is rare. There is varied etiology of gastric necrosis, volvulus being one of them. Gastric volvulus might be associated with other congenital anomalies like eventration, asplenia, wandering spleen. The incidence of perforation in gastric volvulus with necrosis is 5-28% and a mortality of 50% is reported with such perforations. Vigilant clinical observation in pediatric patients with upper abdominal distension and pain can point the diagnosis and prevent fatal outcome.

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Section: Discussionmentioning

confidence: 99%

Extensive gastric necrosis in an infant

et al. 2021

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“…A previous study showed that a low PCIS predicted an unfavorable prognosis of gastric perforation beyond the neonatal period in 20 pediatric patients [ 24 ]. In a retrospective analysis of 45 children with ARDS and hematological neoplasms, the PCIS and average fluid volume in the first 3 days were independent risk factors for predicting death [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for air leakage during invasive mechanical ventilation in pediatric intensive care units

Yin

Yang

et al. 2022

Eur J Med Res

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Purpose This study aimed to investigate air leakage during invasive mechanical ventilation (IMV) in a pediatric intensive care unit (PICU) and explore potential risk factors. Methods We conducted a retrospective cohort study of children who underwent IMV in a single-center PICU in a tertiary referral hospital. Air leakage risk factors and factors associated with an improved outcome were assessed. Results A total of 548 children who underwent IMV were enrolled in this study. Air leakage occurred in 7.5% (41/548) of the cases in the PICU. Air leakage increased the duration of IMV and hospitalization time. Multivariate logistic regression analysis showed a higher risk of air leakage during IMV for PICU patients with acute respiratory dyspnea syndrome (ARDS) (OR = 4.38), a higher pediatric critical illness score (PCIS) (OR = 1.08), or a higher peak inspiratory pressure (PIP) (OR = 1.08), whereas the risk was lower for patients with central respiratory failure (OR = 0.14). The logistic model had excellent predictive power for air leakage, with an area under the curve of 0.883 and tenfold cross-validation. Patients aged between 1 and 6 years who were diagnosed with measles or pneumonia and had a low positive end-expiratory pressure (PEEP) or high PaO2/FiO2 ratio were associated with improved outcomes. Patients diagnosed with central respiratory failure or congenital heart diseases were associated with less desirable outcomes. Conclusions Patients with ARDS, a higher PCIS at admission or a higher PIP were at higher risk of air leakage.

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“…Paediatric critical illness score (PCIS) help to evaluate the gravity of illness in paediatric patients. 19 PCIS calculated before surgery, it includes patient's age and ten physiological indices. These indices are heart rate, breath rate, systolic blood pressure, oxygen partial pressure and pH of arterial blood, serum sodium and potassium, creatinine or urea nitrogen, hemoglobin and Glasgow coma scale.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous gastric perforation in a 3 year old male child – A case report

Singh¹,

Barolia

Bathia³

et al. 2021

IJPNS

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spontaneous gastric perforation in paediatric patients beyond the neonatal age is seldom to seen by paediatric surgeon. Therefore we are sharing this case with enlisting the previously reported similar cases in English literature. a three year old male child presented with abdominal distension and hypovolemic shock. Free gas under diaphragm was explained the perforation and exploration confirm the gastric perforation. spontaneous gastric perforation is extremely rare in paediatric age group beyond the neonatal age group, but incidence probability is always there. So, each laparotomy needed exploration of stomach also.

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Pediatric gastric perforation beyond neonatal period: 8-year experience with 20 patients

Cited by 6 publications

References 26 publications

Extensive gastric necrosis in an infant

Extensive gastric necrosis in an infant

Risk factors for air leakage during invasive mechanical ventilation in pediatric intensive care units

Spontaneous gastric perforation in a 3 year old male child – A case report

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