Gastrointestinal Perforation in Neonates: Aetiology and Risk factors (original) (raw)
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Neonatal intestinal perforation in a developing country
Annals of Tropical Paediatrics: International Child Health, 2001
Median age at presentation was 9 days and median weight 2.65 kg. Five had high anorectal malformation, three Hirschsprung's disease and two ruptured exomphalos with bowel strangulation. Gastroschisis, strangulated inguinal hernia, ileal atresia and umbilical sepsis with evisceration accounted for one case each. Two of the perforations were iatrogenic during colostomy construction. Seven perforations were in the small bowel and seven in the colorectum. Three neonates had oedema and tenderness of the anterior abdominal wall, and pneumoperitoneum was seen in abdominal radiographs in two. All the infants had laparotomy, four under local anaesthesia, after resuscitation. Three had simple suture of the perforation, ve had resection with primary anastomosis and six had exteriorization colostomy. Overall, eight (59%) died, ve with colorectal perforation and three with small bowel perforation.
Gastrointestinal perforations in newborns with high mortality: A series of 18 cases
Journal of Neonatal Surgery
Gastrointestinal perforations (GIP) in newborns are serious neonatal conditions that have significant morbidity and mortality, especially in resource constrained setups. This study was done to describe our experience of GIP in neonates and identify the factors leading to high mortality in our setup. We collected 18 cases with GIP in neonates. The average age was 5.7 days (range, 1-7 days). The sex ratio was 0.64. The average time to treatment was 3.3 days (range, 1-10 days). The etiology of GIP was perforated necrotizing enterocolitis (13 patients), spontaneous gastric perforation (2 patients), perforated ileal atresia (1 patient), ileal perforation complicating a strangulated inguinoscrotal hernia (1 patient), and peritonitis after colostomy (1 patient). Mortality was 77.8% (n=14), among which 9 newborns (64.3%) died preoperatively. Prematurity, management delay, and lack of a neonatal intensive care unit were the main poor prognostic factors. Mortality from GIP is still high in ou...
Objectives: We aimed to present our experience on the gastrointestinal (GI) perforations and the factors affecting the outcome. Design: Retrospective study Setting: A tertiary neonatal intensive care unit Subject and Methods: A total of 38 neonates with GI perforation managed in our neonatal intensive care unit during 2005 to 2011 were included into the study. Interventions: The patients were grouped as necrotizing enterocolitis (NEC) and non-NEC patients. Results: Twenty four of 38 infants (63.2%) were premature. Non-NEC conditions were most common cause of the perforation (57.9%). Twelve cases were managed with peritoneal drainage alone. Surgical repair without conservative approach was performed in 19 patients, while seven of the patients underwent to surgical intervention after decompression by the percutaneous drainage. The overall mortality rate was 28.9%. It were 43.7% and 18.1% in NEC and non-NEC group, respectively (p>0.05). The mortality rate in small bowel perforation ...
Final Neonatal GI Perforations -papar.docx
Objective: To look for pathological causes of Gastrointestinal perforations in neonates and evaluation of current modalities of surgical management and their outcome. Design: Retrospective study Place & Duration of study: Department of Pediatric Surgery , The Children’s Hospital & the institute of child health , Lahore Pakistan. Patients and Methods: Between January 2011 to January 2013, a total of forty eight neonates with GI perforations were managed .Birth weight, age, clinical presentation, etiology, site of perforation, surgical management performed and complications encountered are analyzed. Results: 60% of patients (28/48) had appropriate birth weight where as 31% (14/48) had low birth weight. Most of the patients (35/48) were males. Exclusive number (83%) i.e 38 out of total of 48 presented in first week of life. Most of the patients presented with abdominal distension, vomiting, constipation and septicemia. Apart from usual investigations, exploration was performed on the basis of pneumoperitoneum on abdominal x-rays. There were 28 cases of NEC, 10 of meconeum ileus, 03 with gastric perforation and 04 of anorectal malformations. 2 cases of colonic atresia and 1 of Hirschsprung's disease were included in the study. The complications encountered in these cases included septicemia, abdominal wound infection, leakage of anastomosis and stoma related complications like bleeding, necrosis and retraction. The mortality in study was 16 patients comprising 09 cases of NEC ,5 cases of complicated meconeum ileus, 01 case of imperforate anus and 01 case of colonic atresia . Conclusion: Gastrointestinal perforation in the neonatal age is a common manifestation of various disease entities and management of these neonates requires understanding of these pathological entities. Septicemia and late presentation of patients to hospital is responsible for high morbidity and mortality in these tiny sick neonates in our setup. Keywords: Gastrointestinal perforation, Neonate, Pneumoperitoneum.
Idiopathic colonic and gastric perforation in a full term newborn
International Journal of Surgery Science
Idiopathic Perforation of the transverse colon in neonate is a rare finding in clinical practice. We reported a case of Idiopathic neonatal colonic perforation, colic perforation is an extremely rare condition and very few cases have been reported in a full term newborn. We reported the first case of a new born at 39 weeks of gestation, who, twelve days after birth, had pneumoperitoneum without any demonstrable cause. Surgical exploration showed a transverse colonic perforation, the perforation was closed primarily. The postoperative course was simple, the following up was made every two weeks during six months. The second case Spontaneous neonatal gastric perforation is rare. We report the case of a full term 4-day old newborn who required resuscitation at birth. On the second day of life he had extensive abdominal distension. Abdominal x-ray without preparation showed pneumoperitoneum. Laparotomy showed a perforation at the level of the antrepyloric, measuring 1,5 cm in diameter, treated by simple surgical suture. The patient dead on the first post-operative day.
Spontaneous Intestinal Perforation in Neonate
Jurnal Kesehatan Andalas, 2019
Spontaneous Intestinal Perforation (SIP) terjadi pada 8,4 persen bayi dengan berat badan lahir sangat rendah. SIP ditandai dengan onset mendadak dan tidak ditemukannya tanda infeksi. Presentasi klinis SIP pada bayi bervariasi, dan etiologinya belum diketahui secara pasti. Konsekuensi klinis SIP dapat menimbulkan komplikasi yang cukup parah sehingga dokter harus menyadari kemungkinan penyebab dan gejala. Terapi utama SIP yaitu: drainase peritoneum dan laparotomi dengan reseksi. Dilaporkan kasus SIP pada by perempuan usia 2 hari, yang didiagnosis berdasarkan gejala klinis dan rontgen abdomen. Pasien dilakukan pemasangan drainase di abdomen dan mengamai perbaikan klinis.
Spontaneous Intestinal Perforation in Neonates
2007
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Intestinal perforation in very preterm neonates: risk factors and outcomes
on behalf of the Canadian Neonatal Network 7 OBJECTIVE: To compare neonatal outcomes of preterm infants (born at o32 weeks' gestation) with focal/spontaneous intestinal perforation (SIP), necrotizing enterocolitis (NEC)-related perforation, NEC without perforation or no NEC/perforation. STUDY DESIGN: Retrospective cohort study of 17 426 infants admitted to Canadian neonatal intensive care units during 2010 to 2013. The primary outcome was a composite of mortality or morbidity (bronchopulmonary dysplasia, severe retinopathy, periventricular leukomalacia or nosocomial infection). Association of intestinal perforation with neonatal outcome was evaluated using multivariate logistic regression. RESULT: SIP was present in 178 (1.0%) infants, NEC-related perforation in 246 (1.4%) and NEC without perforation in 538 (3.1%). Any intestinal perforation was associated with higher odds of the composite outcome (adjusted odds ratio (AOR): 8.21, 95% confidence interval (95% CI) 6.26 to 10.8); however, the odds were significantly lower for focal/SIP compared with NEC-related perforation (AOR: 0.29, 95% CI 0.17 to 0.51). CONCLUSION: Of the two types of intestinal perforation, NEC-related perforation was associated with the highest risk of an adverse neonatal outcome.
Spontaneous Intestinal Perforation in Prematurity: A Case Report and Review of Literature
2017
Spontaneous Intestinal Perforation (SIP) refers to a perforation in the gastrointestinal tract of a newborn with no demonstrable cause. This clinical entity is frequently seen in preterm newborns with Very Low Birth Weight (VLBW) and Extremely Low Birth Weight (ELBW) and typically found in the terminal ileum [1-4]. In this report management of a SIP in a preterm infant with ELBW is presented and discussed under the light of relevant literature.