Etiology of neonatal gastric perforation: a review of 20 years’ experience

Terui, Keita; Iwai, Jun; Yamada, Shin‐ichi; Takenouchi, Ayako; Nakata, M.; Komatsu, Shojiro; Yoshida, Hideo

doi:10.1007/s00383-011-3003-4

Cited by 45 publications

(37 citation statements)

References 26 publications

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“…Multiple mechanisms can be implicated in the literature to explain the development of iatrogenic perforations, including selective gut ischemia [2], obstruction secondary to pyloric or duodenal atresia [3,10,11], as a result of indomethacin or dexamethasone therapy administered during pregnancy [4], or as a result of NG tube placement, mechanical ventilation, or complications arising from esophageal atresia with distal tracheoesophageal fistula [6,11,12]. The noniatrogenic form of NGP, where none of the earlier mechanisms are identified, is very rare.…”

Section: Discussionmentioning

confidence: 98%

Noniatrogenic Neonatal Gastric Perforation: The Role of Interstitial Cells of Cajal

Jactel

Abramowsky

Schniederjan

et al. 2013

Fetal and Pediatric Pathology

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Noniatrogenic neonatal gastric perforation is a rare and life-threatening condition whose etiology is often unclear. Interstitial cells of Cajal act as gastrointestinal pacemaker cells and express the proto-oncogene c-Kit. Six new cases were identified at our institution which presented with no mechanical, pharmacologic, or otherwise medical-related intervention prior to rupture. The number of interstitial cells of Cajal in nonnecrotic muscularis propria from five random high-power fields per specimen was compared using immunohistochemical stains for c-Kit. The authors show that a lack of interstitial cells of Cajal in the stomach musculature may be implicated in the development of noniatrogenic gastric perforation (p = 0.008). Further large-scale studies, including molecular and genetic analysis, may help to better understand this phenomenon.

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Section: Discussionmentioning

confidence: 98%

Noniatrogenic Neonatal Gastric Perforation: The Role of Interstitial Cells of Cajal

Jactel

Abramowsky

Schniederjan

et al. 2013

Fetal and Pediatric Pathology

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“…Risk factors for gastric perforation in neonates include low birth weight, trachea-esophageal fistula, chorioamnionitis, intestinal obstruction, malrotation, and postnatal steroid therapy. 7,8 Spontaneous gastric perforation in otherwise healthy infants usually occurs within the first week of life, and one hypothesis is that it is due to congenital defects in the muscular wall of the stomach. The circular muscle layer of the newborn stomach normally contains several gaps, most prominent in the fundus near the greater curvatures.…”

Section: Discussionmentioning

confidence: 99%

Methicillin-Resistant Staphylococcus aureus Subhepatic Abscess Presenting as Pylorospasm in a Neonate

Kalyanaraman

Espiritu-Fuller²,

Raghava³

et al. 2016

Pediatric Emergency Care

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“…Нарушение эвакуации из желудка, обусловленное анатомическими причинами, такими как дуоденальная атрезия (особенно в сочетании с атрезией пищевода и дистальной трахеопищеводной фистулой), атрезия привратника, мальротация, может вызвать избыточное скопление газа и содержимого в просвете желудка, способствуя увеличению внутрипросветного давления и разрыву стенки желудка [30,34]. Мы также обнаружили перфорацию желудка у четырех пациентов с атрезиями различных отделов пищеварительного тракта (три -атрезия пищевода, один -атрезия двенадцатиперстной кишки).…”

Section: дискуссияunclassified

Surgical Treatment of Neonates With Gastric Perforation

Kozlov

Козлов²,

Распутин

et al. 2019

jour

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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.

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Etiology of neonatal gastric perforation: a review of 20 years’ experience

Abstract: The proportion of patients with GP and distal obstruction increased and true "spontaneous" cases of GP decreased over time. The possible presence of distal obstruction should be evaluated during surgery for GP.

Cited by 45 publications

References 26 publications

Noniatrogenic Neonatal Gastric Perforation: The Role of Interstitial Cells of Cajal

Noniatrogenic Neonatal Gastric Perforation: The Role of Interstitial Cells of Cajal

Methicillin-Resistant Staphylococcus aureus Subhepatic Abscess Presenting as Pylorospasm in a Neonate

Surgical Treatment of Neonates With Gastric Perforation

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