Etiology of neonatal gastric perforations: Review of 10 years’ experience

Abstract

Contrary to previous literature, and similar to recent publications, it was found that essentially low-birthweight infants with tracheaesophageal fistula or chorioamnionitis and full-term babies on steroid therapy may have a risk for NGP, suggesting that an infant with contributing factors should be monitored more carefully for the development of NGP.

Neonatal Gastric Perforations: Are They Really Spontaneous?

“…Signs and symptoms of gastric perforation include sudden onset of abdominal distention capable of compromising ventilatory support, increased gastric residue, tenderness, lethargy, and apnea. In some cases, it is accompanied by bilious vomiting, features of sepsis, and it can progress into shock and respiratory failure [2,4]. Differential diagnoses include necrotizing enterocolitis, septicemia, intestinal obstruction, spontaneous pneumoperitoneum without gastrointestinal perforation, and others.…”

“…Legar et al reported the first successful repair of gastric perforation in a newborn in 1950 [1,2]. The etiology and pathogenesis of gastric perforation in the neonatal period are still unknown, although premature birth and low birth weight are known risk factors.…”

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

“…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.…”

A newborn with duodenal atresia and a gastric perforation

“…The mortality is significantly higher in premature than in term infants. [9,10] Congenital duodenal atresia is not rare, with an incidence of about 1 per 5000-10,000 live births. [11] The clinical presentation of duodenal obstruction is usually characterized by feeding intolerance and vomiting in the first 48 h of life.…”