Huang Xiong,Chen Faling,Sheng Qingfeng,et al. Clinical diagnosis and treatment of neonatal gastric perforation:a report of 13 cases.[J].Journal of Clinical Pediatric Surgery,,17():858-861.
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 Clinical diagnosis and treatment of neonatal gastric perforation:a report of 13 cases.

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第17卷 Number: 2018 11 Page: 858-861 Column: 论著 Date of publication: 2018-11-20
Author(s):
 Huang Xiong; Chen Faling; Sheng Qingfeng; Wu Yibo; Sun Jun; Xu Weijue.
 Department of General Surgery,Affiliated Shanghai Children’s Hospital,Shanghai Jiao Tong University,Shanghai 200062,China
Keywords:
 ; Neonatal;  Gastric Perforation;  Gastrointestinal Deformity;  Surgical Procedures;  Operative;  Prognosis
Document code:
A
Abstract:
 ObjectiveTo summarize our experience of clinical diagnosis and treatment of neonatal gastric perforation (NGP).MethodsThe clinical data were retrospectively analyzed for 13 NGP neonates undergoing surgical interventions from September 2010 to December 2016.The clinical data included gender,gestational age,weight,symptom onset,surgical approaches and patient outcomes.ResultsAmong them,there were 7 lowbirthweight cases (53.85%) and 9 preterm neonates (69.23%).Radiography indicated pneumoperitoneum in all patients.Blood gas analysis revealed acidosis (PH<7.35) (n=8,61.54%).Perforation length was ＜2 cm (n=2,15.38%),between 2 to 5 cm (n=6,46.15%) and ＞5 cm (n=5,38.46%).All symptoms appeared within 1 week after birth.According to time from symptoms to surgery,11 cases (n=11,84.61%) were ＜24 h and the remainder (n=2,15.29%)＞24 h (one case of mortality).The sites of perforation were located on anterior gastric wall (23.08%),posterior gastric wall (n=2,15.29%),greater curvature (n=5,38.46%),lesser curvature (n=2,15.29%) and anterior & posterior gastric walls (n=1,7.69%).All 13 patients were operated with a survival rate of 92.31% (12/13).Pathological examinations revealed gastric musculature defects (n=9,69.23%),gastric myometrial dysplasia (n=1,7.69%) and ischemic necrosis (n=3,23.08%).ConclusionNGP occurs frequently in preterm and lowbirthweight neonates.Anterior gastric wall and greater curvature are common perforation positions.Gastric musculature defect is a leading cause of NGP.Active perinatal management,early treatment of primary disease and digestive tract malformation improve patient outcomes.
Last Update: 2018-11-23