Pediatrics & Neonatology
Volume 49, Issue 3 , Pages 65-70, June 2008

Neonatal Gastric Perforation: Report of 15 Cases and Review of the Literature

  • Chieh-Mo Lin

      Affiliations

    • Department of Pediatrics, Jen-Ai Hospital, Taichung, Taiwan
    • Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Hung-Chang Lee

      Affiliations

    • Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
    • Department of Pediatrics, Taipei Medical University, Taipei, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Pediatrics, Mackay Memorial Hospital, 92, Section 2, Chung San North Road, Taipei, Taiwan
    • ,
  • Hsin-An Kao

      Affiliations

    • Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Han-Yang Hung

      Affiliations

    • Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Chyong-Hsin Hsu

      Affiliations

    • Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Chun-Yan Yeung

      Affiliations

    • Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Jin-Cherng Sheu

      Affiliations

    • Department of Pediatric Surgery, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Nien-Lu Wang

      Affiliations

    • Department of Pediatric Surgery, Mackay Memorial Hospital, Taipei, Taiwan

Received 7 October 2005; received in revised form 27 February 2008; accepted 25 June 2008.

Article Outline

Background

Gastric perforation among neonates is a rare but frequently fatal condition of uncertain etiology. The aim of this study was to review the clinical course of neonatal gastric perforation and to evaluate possible prognostic factors.

Methods

We retrospectively analyzed the medical records of 15 patients with neonatal gastric perforation over a 19-year period. Another 97 patients described in the medical literature, for whom the gestational ages and birth weights were clearly stated, were also reviewed.

Results

In our series, there were three girls and 12 boys, nine of whom were fullterm infants and six preterm infants. The most common initial manifestations were poor activity, abdominal distension, and respiratory distress. The overall mortality was 47% (7/15). Prematurity was the only statistically significant risk factor; 83% (5/6) of premature infants died compared with 22% (2/9) of term babies (p < 0.05). Combining our series with the patients reported in the literature, there were a total of 50 premature infants and 62 term infants. Gastric perforation occurred on postnatal days 2–7 and presented with nonspecific manifestations. The mortality was significantly higher in premature than in term infants (31/50, 62% vs. 16/62, 26%; p < 0.001). A trend towards higher mortality in infants with lower birth weights was observed (> 2500 g, 28%; 1501–2500 g, 52%; 1000–1500 g, 60%; < 1000 g, 100%). Infants with birth weights < 2500 g had a significantly higher mortality than infants with birth weights > 2500 g (32/58, 55% vs. 15/54, 28%; p < 0.05).

Conclusion

Neonatal gastric perforation is associated with high mortality, particularly in premature infants. There is also a trend towards higher mortality in lowerbirth-weight infants.

Key Words:  gastric perforation , low-birth-weight , neonate

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PII: S1875-9572(08)60015-7

doi:10.1016/S1875-9572(08)60015-7

Pediatrics & Neonatology
Volume 49, Issue 3 , Pages 65-70, June 2008

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