SURGICAL TREATMENT OF NEONATES WITH GASTRIC PERFORATION

Abstract

Introduction. Gastric perforation in neonates is a rare disease with high post-operative lethality. The purpose of our study was to analyze risk factors of gastric peroration in neonates and present the surgical treatment outcomes. Materials and methods. We examined the outcomes of surgical treatment of 18 neonates with gastric perforation. At the time of surgery, they have been staying at Ivan and Matryona Children’s Clinical Hospital since January 2000. Demographic measures such as gestational age, after-birth age, gender, and weight at birth are discussed. Risk factors for gastric perforation, gastric lesion localization and disease-related lethality were estimated. Results. We observed 18 premature children with gastric perforation amounting to 13.6% of the total number of children with gastrointestinal perforations. The patients were 1 to 30 days old (mean age of 6.3 days). Mean gestational age was 34 weeks. The weight ranged from 950 to 2.600 g (mean body mass was 2,151.8 g). 10 (55.5%) children had a gastric defect on the greater curvature, 2 (11.1%) children had it on the lesser curvature and 6 (33.3%) patients had the defect on the posterior wall of the stomach. In newborns with gastric perforation, post-operative lethality was 33.3% (n = 6). Conclusion. Preliminary abdominal paracentesis and drainage of the abdominal cavity with multiple organ failure correction until the basic surgery stage will probably improve treatment outcomes and decrease lethality due to decreased pressure in the abdominal cavity.