Gastrointestinal Perforations in Neonatal Period

Sakellaris, George; Partalis, Nikolaos; Dede, Olga; Alegakis, Athanasios; Seremeti, Chrisa; Korakaki, Eftichia; Giannakopoulou, Christina

doi:10.1097/pec.0b013e31826beb0c

Cited by 18 publications

(15 citation statements)

References 23 publications

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“…Bowel perforation is a life-threatening complication of NEC in premature infants [ 6 ]. This complication is associated with mortality as high as 76% [ 7 ] and long-term complications among survivors, such as short bowel syndrome, growth and developmental retardation, and adverse neurological outcome [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Bowel Perforation in Premature Infants with Necrotizing Enterocolitis: Risk Factors and Outcomes

Tian

Zhao

et al. 2016

Gastroenterology Research and Practice

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We aim to determine risk factors and clinical outcomes for bowel perforation in premature infants with NEC. We analyzed clinical data of 57 cases of premature infants with NEC at our NICU between January 2010 and December 2012. Based on the presence of bowel perforation, we divided these infants into two groups: perforated NEC group (n = 10) and nonperforated NEC group (n = 47). We compared general information, clinical characteristics, and laboratory findings between groups. The perforated NEC group, compared to the nonperforated NEC group, had significantly lesser gestational age, lower birth weight, higher prevalence of apnea, mechanical ventilation, sepsis and shock, lower blood pH, higher levels of blood glucose, abnormal WBC count and thrombocytopenia, and elevated CRP (all P < 0.05). Moreover, the perforated NEC group had significantly longer durations of fasting and TPN usage, higher incidences of EUGR and cholestasis, longer duration of antibiotics, higher frequency of advanced antibiotics use, and poorer prognosis than the nonperforated NEC group (all P < 0.05). Bowel perforation in premature infants with NEC was associated with multiple risk factors. Early identification of some of these risk factors in premature infants with NEC may help implement early intervention to reduce the incidence of bowel perforation and thereby improve the prognosis.

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Section: Introductionmentioning

confidence: 99%

Bowel Perforation in Premature Infants with Necrotizing Enterocolitis: Risk Factors and Outcomes

Tian

Zhao

et al. 2016

Gastroenterology Research and Practice

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“…GIPs can occur at any age, but are most common in the neonatal period as a complication of necrotizing enterocolitis [71112]. It may occur in older children as a result of trauma, other inflammatory gastrointestinal problems, or iatrogenic events, etc.…”

Section: Discussionmentioning

confidence: 99%

Clinical implication of spontaneous gastrointestinal perforation in pediatric patients: its difference according to age group

et al. 2018

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PurposeSpontaneous gastrointestinal perforations (SGIPs; not associated with injury or disease) occur rarely in pediatric patients. This study aimed to define age-specific features associated with SGIPs in pediatric patients.MethodsRetrospectively reviewed the clinical data of children (before adolescence) who received surgery due to a SGIP at a single institution. Thirty-nine patients were enrolled. Characteristics were compared between the 2 age groups: neonates (group A) and beyond neonates (group B).ResultsGroup A included 24 patients (61.5%) an group B included 15 patients (38.5%). Thirteen perforations occurred in the stomach (33.3%), 12 in the small intestine (30.8%), and 14 in the large intestine (35.9%). A significantly higher proportion of perforations occurred in the stomach and small intestine in group A, while more perforations occurred in the large intestine in group B (P = 0.01). Several associated conditions during the preoperative period were identified in both groups. The overall mortality rate was 15.4% (6 of 39). Mortality was relatively high in group A (5 of 24, 20.8%) and for perforations of stomach (3 of 13, 23.1%) and small intestine (3 of 12, 25.0%); however, there were no significant differences with regard to age or perforation site (P = 0.244, P = 0.122, respectively).ConclusionSGIPs in pediatric patients had diverse clinical features and different perforation patterns according to age group. However, no significant group differences in mortality were found. Thus, favorable results regardless of age can be expected with prompt recognition, medical resuscitation, and adequate surgical management.

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“…In the literature, the most common site of GIP is small intestine, in particular distal ileum[ 22 - 24 ]. Colon perforation is considered a rare event; however, in a recent study, Sakellaris et al[ 25 ] found colon perforation in 18.5% of newborns. According to literature reports, colon perforation is more common in high birth weight newborns (> 2500 g), which predominated in our study sample (65.7%)[ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Perinatal risk factors in newborns with gastrointestinal perforation

Prgomet

Lukšić

Pogorelić

et al. 2017

WJGS

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AIMTo investigate correlation of perinatal risk factors in newborns with gastrointestinal perforation (GIP).METHODSSingle-center retrospective cohort study was conducted between January 1990 and December 2012. Medical records on all newborns with GIP were reviewed (n = 35). Surgical records and histopathologic examination of all perforated intestine samples were also reviewed.RESULTSThe most common cause of GIP was necrotizing enterocolitis (51.4%). The most common site of perforation was large intestine. Mortality rate was 31%. Infants with GIP more frequently had very low birth weight (< 1500 g), especially birth weight below 10th percentile according to gestational age. Ponderal index was not differing between infants with GIP and control subjects. In infants with GIP anemia was more frequently found than in control group.CONCLUSIONGIP in newborns is mostly disease of infants with birth weight below 10th percentile according to gestational age. GIP occurs more often in infants with anemia.

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Gastrointestinal Perforations in Neonatal Period

Cited by 18 publications

References 23 publications

Bowel Perforation in Premature Infants with Necrotizing Enterocolitis: Risk Factors and Outcomes

Bowel Perforation in Premature Infants with Necrotizing Enterocolitis: Risk Factors and Outcomes

Clinical implication of spontaneous gastrointestinal perforation in pediatric patients: its difference according to age group

Perinatal risk factors in newborns with gastrointestinal perforation

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