Neonatal Sleeve Gastrectomy for Multiple Gastric Perforations: A Case Report

Abstract

Neonatal gastric perforation (NGP) may be spontaneous, secondary to necrotizing enterocolitis (NEC), or due to distal obstruction. A 27-week old premature male newborn presented with pneumoperitoneum. A single perforation of stomach was found at surgery. Primary repair and gastrostomy were performed. On fifth postoperative day, pneumoperitoneum was again detected. At reoperation, multiple gastric perforations of the greater curvature were found. Sleeve gastrectomy was performed. The patient responded well to the treatment.

Sleeve gastrectomy for multiple gastric perforations in a preterm: A case report

“…However, sleeve gastrectomy has also been tried as a therapeutic option for multiple gastric perforations in neonates when there is adequate vasculature in the lesser curvature. Sleeve gastrectomy preserves the gastric chamber and maintains esophageal, gastric, and duodenal continuity compared with total gastrectomy, which has high morbidity and mortality 3 . However, there is always a risk of intestinal obstruction owing to adhesions, stricture formation, internal hernia, delayed gastric emptying, and nutritional deficiencies 21 …”

“…Sleeve gastrectomy preserves the gastric chamber and maintains esophageal, gastric, and duodenal continuity compared with total gastrectomy, which has high morbidity and mortality. 3 However, there is always a risk of intestinal obstruction owing to adhesions, stricture formation, internal hernia, delayed gastric emptying, and nutritional deficiencies. 21 Preterm and LBW babies are at increased risk of mortality as compared to full-term neonates.…”

“…To our best knowledge, this is the second case report of sleeve gastrectomy performed for multiple gastric perforations in a premature neonate. 3…”

“…It often occurs without any apparent precipitating event, after which patients deteriorate rapidly 2 . Gastric perforations can also occur in the setting of necrotizing enterocolitis (NEC), distal obstruction, or secondary to trauma usually as the result of gastric tube insertion or attempted intubation 3,4 . Most of the time (about 85%–90%), the perforation is single and linear; multiple gastric perforations are rare 5 …”

“…2 Gastric perforations can also occur in the setting of necrotizing enterocolitis (NEC), distal obstruction, or secondary to trauma usually as the result of gastric tube insertion or attempted intubation. 3,4 Most of the time (about 85%-90%), the perforation is single and linear; multiple gastric perforations are rare. 5 We report a case of 33-week preterm with multiple gastric perforations in whom a sleeve gastrectomy was successfully performed.…”