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Related Experiment Videos

Neonatal gastrointestinal perforations.

D St-Vil1, G LeBouthillier, F I Luks

  • 1Department of Surgery, Hôpital Ste-Justine, Montreal, Quebec, Canada.

Journal of Pediatric Surgery
|October 1, 1992
PubMed
Summary
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Neonatal gastrointestinal perforation remains a serious condition with a 36% mortality rate, primarily driven by necrotizing enterocolitis (NEC). While survival has not significantly improved, prognostic factors beyond birth weight are becoming more critical.

Area of Science:

  • Neonatal Surgery
  • Pediatric Gastroenterology
  • Critical Care Medicine

Background:

  • Neonatal gastrointestinal perforation carries a high mortality rate, ranging from 40% to 70%.
  • Necrotizing enterocolitis (NEC) is a leading cause of perforation in neonates.
  • Past treatment strategies have focused on surgical intervention, with varying outcomes.

Purpose of the Study:

  • To analyze the outcomes of neonatal gastrointestinal perforation over a 20-year period.
  • To identify the primary etiologies and prognostic factors associated with neonatal gastrointestinal perforation.
  • To evaluate trends in mortality and survival rates in this patient population.

Main Methods:

  • Retrospective review of 81 infants treated for gastrointestinal perforation.

Related Experiment Videos

  • Classification of etiologies including necrotizing enterocolitis, meconium ileus, and idiopathic gastric perforation.
  • Comparison of outcomes between surgical exploration and peritoneal lavage, and analysis of mortality based on etiology and birth weight.

    • Main Results:

    • Overall mortality was 36% (29 deaths) in 81 treated infants.
    • Necrotizing enterocolitis (NEC) accounted for 68% of perforations and 90% of deaths.
    • All patients with idiopathic gastric perforations survived, and the mortality gap between low and normal birth weight infants narrowed.

    Conclusions:

    • Neonatal gastrointestinal perforation, particularly NEC-related, continues to have a significant mortality rate.
    • Etiology and perforation site are increasingly important prognostic indicators, surpassing birth weight.
    • Despite advances, survival rates have not markedly improved, necessitating further research into underlying causes and targeted interventions.