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Acute gastric dilatation complicating the use of mydriatics in a preterm newborn

S U Sarici1, M Yurdakök, S Unal

  • 1Department of Paediatrics, Ihsan Doğramaci Children's Hospital, Hacettepe University School of Medicine, Ankara, Turkey. susarici@hotmail.com

Pediatric Radiology
|September 12, 2001
PubMed

Insights

A premature infant developed acute gastric dilatation after eye drops for retinopathy of prematurity screening. Symptoms resolved spontaneously, highlighting a potential adverse effect of these medications in preterm infants.

Area of Science:

  • Ophthalmology
  • Neonatology
  • Pediatric Gastroenterology

Background:

  • Retinopathy of prematurity (ROP) screening is crucial for preterm infants.
  • Ophthalmic medications like cyclopentolate and phenylephrine are commonly used for ROP examinations.
  • Premature infants may have unique physiological responses to medications.

Observation:

  • A 2-month-old infant, born at 27 weeks' gestation, underwent ROP screening.
  • The infant received topical cyclopentolate 0.5% and phenylephrine 2.5% eye drops.
  • Two hours post-examination, the infant exhibited apnea, vomiting, and abdominal distension.

Findings:

  • Abdominal radiography confirmed acute gastric dilatation in the infant.
  • The infant's symptoms, including apnea, vomiting, and distension, resolved within 18 hours.
  • Repeat radiography showed complete resolution of gastric dilatation.

Implications:

  • Topical cyclopentolate and phenylephrine may induce acute gastric dilatation in susceptible preterm infants.
  • This case suggests a potential adverse drug reaction requiring careful monitoring in neonates.
  • Further investigation into the mechanism and incidence of this reaction is warranted.

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