Neonatal gastrointestinal perforation in Japan: a nationwide survey

Sato, Masahito; Hamada, Y.; Kohno, Miyuki; Ise, Kazuya; Uchida, Keiichi; Ogata, Hiromi; Masuyama, Hiroaki; Morotomi, Yoshiki; Yasufuku, Masao; Motoshi, Wada

doi:10.1007/s00383-016-3985-z

Cited by 37 publications

(29 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Accordingly, in 2008 Lin and colleagues reported 15 cases and reviewed the literature, finding higher incidence of NGP among LBW babies (52%) in particular, in extremely LBW neonates, and suggested that premature infants are more prone to develop a spontaneous gastric perforation due to the immaturity of the gastric tissue ( 2 ). Similarly, in the survey from Sato et al ( 45 ), 11 out of 42 neonates with gastric perforation were ELWB. Prematurity may predispose to NGP through several factors, including defects of the gastric muscle wall (especially in immature tissues of preterm babies), lack of intestinal pacemaker cells, and lack of C-KIT mast cell ( 27 ).…”

Section: Discussionmentioning

confidence: 75%

Pathogenetic and Prognostic Factors for Neonatal Gastric Perforation: Personal Experience and Systematic Review of the Literature

et al. 2018

View full text Add to dashboard Cite

IntroductionNeonatal gastric perforation (NGP) is a rare entity. Our aim was to report our experience and review the recent literature to characterize NGP, describe associated factors, and define prognostic factors.Materials and methodsRetrospective review of all consecutive patients with NGP treated between June 2009 and December 2017 in a third level pediatric hospital. In addition, a systematic review of Medline and Scopus database was performed using a defined strategy. All articles referring to NGP published between 2005 and 2017 were retrieved. Variables considered: prematurity (<37 weeks gestation), birth weight (BW), Apgar score, prenatal complications, age at diagnosis, bag ventilation, pathogenetic events, site of perforation, treatment of perforation, sepsis, and outcome. Mann–Whitney or Fisher’s test were used as appropriate. Results are median (range) or prevalence.ResultsBetween 2009 and 2016 we treated 8 consecutive patients for NGP and 199 further cases were retrieved from the systematic review (total of 207 patients). Overall survival was 73%. Most frequently reported pathogenesis: iatrogenic (20 patients), hypoxic/ischemic or infection stress (13 patients), duodenal/jejunal obstruction (11 patients), drugs (11 patients), esophageal atresia (10 patients). 60% patients had only primary repair of the perforation as gastric surgery. Sepsis developed in 56 patients (34%).ConclusionAlthough the pathogenesis of NGP is pleomorphic, prematurity and low BWs are frequent in these patients. Reviewing our experience and the available literature, none of the variables considered, but sepsis was associated with mortality.

show abstract

Section: Discussionmentioning

confidence: 75%

Pathogenetic and Prognostic Factors for Neonatal Gastric Perforation: Personal Experience and Systematic Review of the Literature

et al. 2018

View full text Add to dashboard Cite

show abstract

“…This review included 104 male (61.9%) and 64 female (38.1%); 72 preterm (57.1%) and 54 full-term (42.9%) neonates after 42 cases from the studies by Sato et al were excluded due to the unavailability of data on their gestational age. [ 19 ] The perforation locations included the greater curvature (n = 90; 73.8%), lesser curvature (n = 16; 13.1%), anterior wall (n = 11; 9.0%), and posterior wall (n = 5; 4.1%) after 3, 1, and 42 cases from the studies by Shashikumar et al, Kiesewetter et al, and Sato et al were excluded, respectively, due to the unavailability of data on the location of perforation. [ 11 , 14 , 19 ] Three cases in study of Rosser et al and 1 case in study of Amadeo et al, which the perforation was identified at fundus, were included into group of greater curvature for statistical analysis-based anatomical position.…”

Section: Discussionmentioning

confidence: 99%

Neonatal gastric perforation

et al. 2018

View full text Add to dashboard Cite

Rationale:Neonatal gastric perforation is a rare and life-threatening disorder in neonates and is associated with high morbidity and mortality. However, the exact mechanisms of neonatal gastric perforation remain unknown.Patient concerns:In this study, we reported 2 cases of neonatal gastric perforation and conducted a systematic review to analyze the prognostic factors for mortality.Diagnoses:Two neonates received a diagnosis of gastric perforation based on clinical presentation and imaging studies. The 2 patients underwent emergent surgery, which yielded favorable outcomes.Interventions:We reviewed 168 cases from the literature as well as our 2 cases to analyze whether mortality in neonatal gastric perforation is associated with sex, gestational age, operation type, perforation location, or timing of perforation.Outcomes:The results revealed that mortality was significantly higher in preterm neonates (n = 80, P < .01) and the mortality group had a lower birth weight (n = 73, P < .05). The timing of perforation in the preterm subgroup was significantly earlier than that in the full-term subgroup (n = 90, P < .05). The outcomes about mortality of gastric perforation were significantly associated with preterm neonates (adjusted odds ratio: 4.21, 95% confidence interval: 1.28–13.88, P < .05).Lessons:This study shows the prognostic factor of gastric perforation was significantly associated with preterm neonates. Furthermore, low-birth-weight full-term neonates had a relatively higher mortality rate than the normal-birth-weight full-term neonates. In addition, preterm neonates have an earlier timing of perforation.

show abstract

“…On the other hand, the response rate of level III perinatal centers (77.6%) was high, considerably higher than those of other recent nationwide surveys in Japan, such as 70.7% in a survey of the need for human milk banking, 10 64% for clinical kernicterus in preterm infants, 28 62.3% for neonatal transportation practices, 29 and 57.7% for neonatal gastrointestinal perforation. 30 In addition, a total of 14,934 VLBWI admitted to the level III perinatal centers that completed our questionnaire accounted for 69.4% (14,934/21,518) of the VLBWI admitted to all perinatal centers responding to this survey. Another limitation of this study is that we did not assess data about feeding intolerance because it is difficult to uniformly evaluate feeding intolerance using a questionnaire.…”

Section: Discussionmentioning

confidence: 99%

Feeding interval and use of donor breast milk for very low birthweight infants: A nationwide survey in Japan

Ashina

Fujioka

Totsu

et al. 2019

Pediatrics & Neonatology

View full text Add to dashboard Cite

show abstract

Neonatal gastrointestinal perforation in Japan: a nationwide survey

Abstract: The mortality rates for ELBW decreased from 62.8 % in the previous survey to 41.1 % by the time of this survey.

Cited by 37 publications

References 11 publications

Pathogenetic and Prognostic Factors for Neonatal Gastric Perforation: Personal Experience and Systematic Review of the Literature

Pathogenetic and Prognostic Factors for Neonatal Gastric Perforation: Personal Experience and Systematic Review of the Literature

Neonatal gastric perforation

Feeding interval and use of donor breast milk for very low birthweight infants: A nationwide survey in Japan

Contact Info

Product

Resources

About