SURGICAL TREATMENT OF NEONATES WITH GASTRIC PERFORATION

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Abstract

Introduction. Gastric perforation in neonates is a rare disease with high post-operative lethality. The purpose of our study was to analyze risk factors of gastric peroration in neonates and present the surgical treatment outcomes. Materials and methods. We examined the outcomes of surgical treatment of 18 neonates with gastric perforation. At the time of surgery, they have been staying at Ivan and Matryona Children’s Clinical Hospital since January 2000. Demographic measures such as gestational age, after-birth age, gender, and weight at birth are discussed. Risk factors for gastric perforation, gastric lesion localization and disease-related lethality were estimated. Results. We observed 18 premature children with gastric perforation amounting to 13.6% of the total number of children with gastrointestinal perforations. The patients were 1 to 30 days old (mean age of 6.3 days). Mean gestational age was 34 weeks. The weight ranged from 950 to 2.600 g (mean body mass was 2,151.8 g). 10 (55.5%) children had a gastric defect on the greater curvature, 2 (11.1%) children had it on the lesser curvature and 6 (33.3%) patients had the defect on the posterior wall of the stomach. In newborns with gastric perforation, post-operative lethality was 33.3% (n = 6). Conclusion. Preliminary abdominal paracentesis and drainage of the abdominal cavity with multiple organ failure correction until the basic surgery stage will probably improve treatment outcomes and decrease lethality due to decreased pressure in the abdominal cavity.

About the authors

Yu. A. Kozlov

Irkutsk Municipal Pediatric Clinical Hospital;
Irkutsk State Medical Academy of Continuing Education;
Irkutsk State Medical University Russia

Author for correspondence.
Email: yuriherz@hotmail.com
Head of department of neonatal surgery at Irkutsk Municipal Pediatric Clinical Hospital; professor of the department of pediatric surgery at Irkutsk State Medical University Russia; professor of the department of pediatric surgery at Irkutsk State Medical Academy of Continuing Education Russian Federation

A. A. Rasputin

Irkutsk Municipal Pediatric Clinical Hospital

Email: arasputin@mail.ru
Surgeon of department of neonatal surgery at Irkutsk Municipal Pediatric Clinical Hospital Russian Federation

P. J. Baradieva

Irkutsk Municipal Pediatric Clinical Hospital

Email: p.baradieva@cloud.com
Pedaitric surgeon at Irkutsk Municipal Pediatric Clinical Hospital Russian Federation

Ch. B. Ochirov

Irkutsk Municipal Pediatric Clinical Hospital

Email: Cimitbator@gmail.com
Surgeon of department of neonatal surgery at Irkutsk Municipal Pediatric Clinical Hospital Russian Federation

N. V. Rasputina

Irkutsk Municipal Pediatric Clinical Hospital

Email: Nmalenkina@ya.ru
Neonatologist at Irkutsk Municipal Pediatric Clinical Hospital Russian Federation

G. P. Us

Irkutsk Municipal Pediatric Clinical Hospital

Email: us.galina@mail.ru
Neonatologist at Irkutsk Municipal Pediatric Clinical Hospital Russian Federation

N. N. Kuznetsova

Irkutsk Municipal Pediatric Clinical Hospital

Email: fake@neicon.ru
Neonatologist at Irkutsk Municipal Pediatric Clinical Hospital Russian Federation

M. I. Kononenko

Irkutsk Municipal Pediatric Clinical Hospital

Email: 29marinared74@mail.ru
Neonatologist at Irkutsk Municipal Pediatric Clinical Hospital Russian Federation

References

  1. St-Vil D., LeBouthillier G., Luks F. I., Bensoussan A. L., Blanchard H., Youssef S. Neonatal gastrointestinal perforations. J. Pediatr. Surg. 1992;27:1340–2.
  2. Leone R. S., Krasna I. H. Spontaneous neonatal gastric perforation: is it really spontaneous? J. Pediatr. Surg. 2000;35:1066–9. doi: 10.1053/jpsu.2000.7773
  3. Rosser S. B., Clark C. H., Elechi E. N. Spontaneous neonatal gastric perforation. J. Pediat. r Surg. 1982;17:390–4.
  4. Jawad A. J., Al-Rabie A., Hadi A., Al-Sowailem A., Al-Rawaf A., Abu-Touk B., Al-Karfi T., Al-Sammarai A. Spontaneous neonatal gastric perforation. Pediatr. Surg Int. 2002;18:396–9. doi: 10.1007/s00383–002–0749–8
  5. Pelizzo G., Dubois R., Lapillonne A., Lainé X., Claris O., Bouvier R., Chappuis J. P. Gastric necrosis in newborns: a report of 11 cases. Pediatr Surg Int. 1998;13:346–9. doi: 10.1038/sj.jp.7211589
  6. Attridge J. T., Clark R., Gordon P. V. New insights into spontaneous intestinal perforation using a national data set: antenatal steroids have no adverse association with spontaneous intestinal perforation. J. Perinatol. 2006;26:667–70.
  7. Duran R., Inan M., Vatansever U., Aladag N., Acunas B. Etiology of neonatal gastric perforations: review of 10 years’ experience. Pediatr Int. 2007;49:626–30. doi: 10.1111/j.1442–200X.2007.02427.x
  8. Lin C. M., Lee H. C., Kao H. A., Hung H. Y., Hsu C. H., Yeung C. Y., Sheu J. C., Wang N. L. Neonatal gastric perforation: report of 15 cases and review of the literature. Pediatr. Neonatol. 2008;49:65–70. doi: 10.1016/S1875–9572(08)60015–7
  9. Byun J., Kim H. Y., Noh S. Y., Kim S. H., Jung S. E., Lee S. C., Park K. W. Neonatal gastric perforation: a single center experience. World J. Gastrointest. Surg. 2014;6:151–5. doi: 10.4240/wjgs.v6.i8.151.
  10. Bal Krishna Tripathi, Sisodiya R. S. Gastric perforation in preterm neonate – an infrequent entity. International Journal of Current Advanced Research. 2016; 5:1135–6.
  11. Parrish R. A., Sherman R. T., Wilson H. Spontaneous rupture of gastroenteric tract in the newborn: a report of 13 cases and description of characteristic X-ray finding. Ann. Surg. 1964;159:244–51.
  12. Nagaraj H. S., Sandhu A. S., Cook L. N., Buchino J. J., Graff D. B. Gastrointestinal perforation following indomethacin therapy in very low birth weight infant. J. Pediatr. Surg. 1981;16:1003–7
  13. Wilson E. S. Jr. Neonatal gastric perforation. Am. J. Roentgenol. Radium. Ther. Nucl. Med. 1968;103:307–9.
  14. Reams G. B., Dunaway J. B., Walls W. L. Neonatal gastric perforation with survival. Pediatrics. 1963;31:97–102.
  15. Othersen H. B. Jr., Gregorie H. B. Jr. Pneumatic rupture of the stomach in a newborn infant with esophageal atresia and tracheoesophageal fistula. Surgery. 1963;53:362–7.
  16. Leonidas J., Berdon W. E., Baker D. H., Amoury R. Perforation of the gastrointestinal tract and pneumoperitoneum in newborns treated with continuous lung distending pressures. Pediatr. Radiol. 1974;2:241–5.
  17. Garland J. S., Nelson D. B., Rice T., Neu J. Increased Risk of Gastrointestinal Perforations in Neonates Mechanically Ventilated with Either Face Mask or Nasal Prongs Pediatrics Sep. 1985;76:406–10.
  18. Herbert, Peter A. Congenital Defect in the Musculature of the Stomach with Rupture in a Newborn Infant. Arch. Pathology. 1943;36:91.
  19. Macgillivray P. C., Stewart A. M., Macfarlane A. Rupture of the stomach in the newborn due to congenital defects in the gastric musculature. Arch Dis Child. 1956;31:56–8.
  20. Meyer J. L. 2nd. Congenital defect in the musculature of the stomach resulting in spontaneous gastric perforation in the neonatal period; a report of two cases. J. Pediatr. 1957;51:416–21.
  21. Linkner L. M., Benson C. D. Spontaneous perforation of the stomach in the newborn; analysis of thirteen cases. Ann Surg. 1959;149:525–33.
  22. Shaw A., Blanc W. A., Santulli T. V. Kaiser G. Spontaneous rupture of the stomach in the newborn: a clinical and experimental study. Surgery. 1965;58:561–71.
  23. Munn J., Hussain A. N., Castelli M. J., Diamond S. M., Black P. R. Ileal perforation due to arteriovenous malformation in a premature infant. J. Pediatr. Surg. 1990;25:701–3.
  24. van de Bor M., Walther F. J., Ebrahimi M. Decreased cardiac output in infants of mothers who abused cocaine. Pediatrics. 1990;85:30–2.
  25. Downing G. J., Horner S. R., Kilbride H. W. Characteristics of perinatal cocaine-exposed infants with necrotizing enterocolitis. Am. J. Dis. Child. 1991;145:26–7.
  26. Lu C. P., Teng R. J., Chen M. H., Liao K. S., Ho M. M., Hwang K. C. Intestinal malrotation and gastric perforation in a newborn with tetralogy of Fallot: report of one case. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1992;33:446–9.
  27. Behramn, Kleigman, Jenson: Nelson TEXTBOOK of pediatrics. In: Digestive system disorders. Ed by J. Barbara, Stoll, Kleigman R. M., 17th ed, USA, Sannders, 2004; 590–1.
  28. Aydin M., Zenciroğlu A., Hakan N., Erdoğan D., Okumuş N., Ipek M. S. Gastric perforation in an extremely low birth weight infant recovered with percutaneous peritoneal drainage. Turk. J. Pediatr. 2011;53:467–70.
  29. Grosfeld J. L., Molinari F., Chaet M., Engum S. A., West K. W., Rescorla F. J., Scherer L. R.3rd. Gastrointestinal perforation and peritonitis in infants and children: experience with 179 cases over ten years. Surgery. 1996;120:650–6.
  30. Scherer L. R. Gastrointestinal perforation in the newborn. In J. A. O`Neill et. al.: Pediatric Surgery. 1998;5:1129–31.
  31. Yamataka A., Yamataka T., Kobayashi H., Sueyoshi N., Miyano T. Lack of C-KIT mast cells and the development of idiopathic gastric perforation in neonates. J. Pediatr. Surg. 1999;34:34–8.
  32. Ohshiro K., Yamataka A., Kobayashi H., Hirai S., Miyahara K., Sueyoshi N., Suda K., Miyano T. Idiopathic gastric perforation in neonates and abnormal distribution of intestinal pacemaker cells. J. Pediatr. Surg. 2000;35:673–6. doi: 10.1053/jpsu.2000.5940.
  33. Lee D. K., Shim S. Y., Cho S. J., Park E. A., Lee S. W. Comparison of gastric and other bowel perforations in preterm infants: a review of 20 years experience in a single institution. Korean J. Pediatr. 2015;58:288–93. DOI:10.3345/ kjp.2015.58.8.288.
  34. Terui K., Iwai J., Yamada S., Takenouchi A., Nakata M., Komatsu S., Yoshida H. Etiology of neonatal gastric perforation: a review of 20 years’ experience. Pediatr Surg Int. 2012;28:9–14. doi: 10.1007/s00383–011–3003–4.
  35. Yang C. Y., Lien R., Fu R. H., Chu S. M., Hsu J. F., Lai J. Y., Minoo P., Chiang M. C. Prognostic factors and concomitant anomalies in neonatal gastric perforation. J. Pediatr. Surg. 2015;50:1278–82. doi: 10.1016/j.jpedsurg.2015.04.007.
  36. Chouteau W., Green D. W. Neonatal gastric perforation. J. Perinatol. 2003;23:345–7. doi: 10.1038/sj.jp.7210901.
  37. Kara C. S., Ilce I., Celayir S., Sarimurat N., Erdogan E., Yeker D. Neonatal gastric perforation; review of 23 years’ experience. Surg. Today. 2004;34:243–5. doi: 10.1007/s00595–003–2675–3.
  38. Babayigit A., Ozaydın S., Cetinkaya M., Sander S. Neonatal gastric perforations in very low birth weight infants: a single center experience and review of the literature. Pediatr. Surg. Int. 2018;34:79–84. doi: 10.1007/s00383–017–4205–1.
  39. Yang T., Huang Y., Li J., Zhong W., Tan T., Yu J., Li L., Pan J., Hu C., Yang J., Zou Y. Neonatal Gastric Perforation: Case Series and Literature Review. World J. Surg. 2018;42:2668–73. doi: 10.1007/s00268–018–4509-x.
  40. Bilik R., Freud N., Sheinfeld T., Ben-Ari Y., Rachmel A., Ziv N., Zer M. Subtotal gastrectomy in infancy for perforating necrotizing gastritis. J. Pediatr. Surg. 1990;25:1244–5.
  41. Chen T. Y., Liu H. K., Yang M. C., Yang Y. N., Ko P. J., Su Y. T., Huang R. Y., Tsai C. C. Neonatal gastric perforation: a report of two cases and a systematic review. Medicine (Baltimore). 2018;97: e0369. doi: 10.1097/MD.0000000000010369.

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Copyright (c) 2019 Kozlov Y.A., Rasputin A.A., Baradieva P.J., Ochirov C.B., Rasputina N.V., Us G.P., Kuznetsova N.N., Kononenko M.I.

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