Preterm baby with gastric pneumatosis: a new association with a desirable outcome

Abusalah, Zahreddin Guma; George, Jennifer

doi:10.1136/bcr-2019-230188

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…This is associated with obstructive conditions affecting the gastric outlet [2] or the proximal intestine. [3] There is another serious type called emphysematous gastritis which shows inflammation and ischemia of the gastric mucosa and is often seen in fulminant necrotizing enterocolitis. [4] There have been rare cases of sepsis due gas producing organisms like E.coli, Proteus, Clostridium spp, staph aureus, Enterobacter, etc.…”

Section: Discussionmentioning

confidence: 99%

Gastric pneumatosis in a preterm infant: A case report

Sreekumar,

Raj,

Dey

et al. 2023

J Neonatal Surg

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Background: Gastric pneumatosis is a rare condition characterized by the presence of intramural gas in the stomach wall. It is uncommon in infants and is usually caused by proximal intestinal obstruction or necrotizing enterocolitis, a serious condition typically seen in preterm babies. Case Presentation: An extremely preterm baby born at 23 weeks of gestation weighing 640 grams, with bronchopulmonary dysplasia and other comorbidities like patent ductus arteriosus, staph aureus sepsis, developed abdominal distension and non-bilious vomiting at 4 months of age. X-ray abdomen revealed gastric pneumatosis. The condition was managed with conservative measures. Conclusion: Gastric pneumatosis secondary to necrotizing enterocolitis is uncommon in infants and needs prompt evaluation and management to prevent further deterioration.

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Section: Discussionmentioning

confidence: 99%

Gastric pneumatosis in a preterm infant: A case report

Sreekumar,

Raj,

Dey

et al. 2023

J Neonatal Surg

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“…Gastric pneumatosis is an extremely rare condition and a primarily radiological diagnosis. In infancy, it has been associated with pyloric stenosis 8 , duodenal obstruction 9 , annular pancreas 10 , use of indomethacin with non-invasive respiratory support 11 , jejunal atresia 12 and necrotizing enterocolitis 13 ; in the latter setting, it has been attributed to widespread and severe disease requiring urgent surgical intervention 14 . It may also be secondary to intramural misplacement of a feeding catheter 15 .…”

Section: Discussionmentioning

confidence: 99%

Gastric Pneumatosis in a Preterm Infant: a Case Report and Review of Literature

Bonitatibus

Paterlini

Zanzucchi

et al. 2022

Preprint

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Background: gastric pneumatosis is a rare sign with a primarily radiological diagnosis. In newborn infants, this finding should raise the suspicion of necrotizing enterocolitis, which represents a serious clinical condition with high morbidity and mortality. However, other causes of gastric pneumatosis are reported in literature, including intramural displacement of a feeding tube. In this report we present a case of gastric pneumatosis in a preterm boy admitted to our NICU. Case presentation: the baby appeared pale and poor responsive during the first days of life on positive pressure ventilation and gavage feeding. A distended upper abdomen with bloody and biliary gastric aspirates was noted; no bloody stools were reported. Blood cultures, cerebrospinal fluid culture and blood cell count were normal; acute phase proteins were negative on serial determinations. Abdominal X-Ray showed gastric pneumatosis with displacement of the feeding tube and no other pathological findings in the rest of the bowel. After few days of conservative management, the baby improved dramatically. Conclusions: we suggest that the cause of this clinical picture could have been a mechanical lesion in gastric mucosa caused by the feeding tube; positive pressure ventilation then could have raised intragastric pressure, leading air to diffuse between the layers of the gastric wall.

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“…[2][3][4][5] Other causes of gastric pneumatosis include isolated gastric pneumatosis, sepsis, gastritis, congenital hypertrophic pyloric stenosis, displaced gastric tubes, following steroid and cyclooxygenase inhibitor (COX-inhibitor), for example, Ibuprofen exposure, jejunal atresia and non-invasive positive pressure ventilation, especially in babies with cyanotic congenital heart disease and large patent ductus arteriosus. [6][7][8][9] Learning points ► Initial empiric use of antibiotics should not be routinely administered for preterm infants on delivery as it is strongly associated with intestinal dysbiosis and increased incidence of NEC. ► The use of early antibiotic therapy for preterm infants after delivery should be restricted to indicated cases with risk factors of early-onset sepsis.…”

Section: Images In…mentioning

confidence: 99%