Observational Study
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2014; 6(8): 151-155
Published online Aug 27, 2014. doi: 10.4240/wjgs.v6.i8.151
Neonatal gastric perforation: A single center experience
Jeik Byun, Hyun Young Kim, Seung Yeon Noh, Soo Hong Kim, Sung Eun Jung, Seong Cheol Lee, Kwi Won Park
Jeik Byun, Hyun Young Kim, Seung Yeon Noh, Soo Hong Kim, Sung Eun Jung, Seong Cheol Lee, Kwi Won Park, Department of Pediatric Surgery, Seoul National University Children’s Hospital, Seoul 110-744, South Korea
Author contributions: All the authors contributed to this paper.
Correspondence to: Sung Eun Jung, MD, Department of Pediatric Surgery, Seoul National University Children’s Hospital, 101 Daehang-ro, Yeongeon-dong, Jongro-gu, Seoul 110-744, South Korea. sejung@snu.ac.kr
Telephone: +82-02-20722478 Fax: +82-02-7405130
Received: February 19, 2014
Revised: June 12, 2014
Accepted: July 12, 2014
Published online: August 27, 2014
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: Neonate, Gastric perforation, Etiology, Prognosis, Surgical intervention

Core tip: Neonatal gastric perforation (NGP) is an extremely rare condition and very few cases have been reported to date. We determined the etiology and prognostic factors for NGP in nine cases who were treated at a single center. Early detection and prompt surgical intervention are essential to improve the outcomes of NGP.