Neonatal gastric perforation: A single center experience

Abstract

Aim: To determine the etiology and prognostic factors for neonatal gastric perforation (NGP), a rare but life-threatening disease.

Methods: Between 1980 and 2011, nine patients underwent surgical intervention for NGP at Seoul National University Children's Hospital. The characteristics and prognosis of the patients were retrospectively analyzed.

Results: Among the nine patients, three (33.3%) were preterm babies and five (55.5%) had associated anomalies, which included diaphragmatic eventration (n = 2), congenital diaphragmatic hernia, esophageal atresia with tracheoesophageal fistula, and antral web. Three (33.3%) patients were born before 1990 and three (33.3%) had a birth weight < 2500 g. Pneumoperitoneum was found on preoperative images in six (66.7%) patients, and incidentally in the other three (33.3%) patients. Surgery was performed within 24 h after the onset of symptoms in seven (77.8%) patients. The overall mortality rate was 22.2% (2/9). The time between symptoms and surgical intervention was the only prognostic factor for survival, whereas premature birth and birth weight were not.

Conclusion: Early detection and advances in neonatal intensive care may improve the prognosis of NGP.

Keywords: Etiology; Gastric perforation; Neonate; Prognosis; Surgical intervention.