Clinical Features of Spontaneous Neonatal Gastric Perforation.

Kim,  Eun Ha; Park,  Ji Min; Cho,  Yoon Jung; Lee,  Sang Lak; Kim,  Joon Sik; Park,  Sun Ok; Park,  Woo Hyun

Original Article

Journal of the Korean Society of Neonatology 2001;8(1):46-51.
Published online May 1, 2001.

Clinical Features of Spontaneous Neonatal Gastric Perforation.

Eun Ha Kim, Ji Min Park, Yoon Jung Cho, Sang Lak Lee, Joon Sik Kim, Sun Ok Park, Woo Hyun Park

¹Department of Pediatrics, Keimyung University, School of Medicine, Taegu, Korea.
²Department of Pediatric Surgery, Keimyung University, School of Medicine, Taegu, Korea.

신생아 위 자연 천공의 임상적 특성

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Abstract

PURPOSE
Spontaneous neonatal gastric perforation is a rare neonatal event which is associated with high mortality. The aim of this retrospective study is to investigate the diagnosis and the treatment of neonatal spontaneous gastric perforation.
METHODS
From January 1991 to December 2000, eight cases of neonatal gastric perforation were presented at Keimyung University Dongsan Medical Center.
RESULTS
Among 8 neonates (7 males and 1 females), 2 were premature infants. 7 cases (87.5%) had symptoms onset in first 4 days of life. The most presenting signs were abdominal distension, vomiting, and respiratory difficulty. The most common X-ray finding was pneumoperitoneum (87.5%) and the most common site of perforation was greater curvature (75%). The combined congenital anomalies were malrotation of small intestine, teratoma, and partial duodenal obstruction. The predisposing causes may be associated with congenital intestinal anomaly, necrotizing enterocolitis, and too fast increased formula. All the cases underwent surgical repairs. The mortality rate was 37.5%, and the surgical procedure performed 24 hours after presumed disease onset represented poor outcome (mortality rate 67%). CONCLUSION: This report suggests that early diagnosis and early management before clinical deterioration of metabolic status may improve the prognosis for neonatal spontaneous gastric perforation patient.

Key Words: Spontaneous gastric perforation; Neonate