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Neonatal gastrointestinal perforations.

R H Merchant1, V S Sakhalkar, K N Shah

  • 1Department of Pediatrics (Division of Neonatology), Bai Jerbai Wadia Hospital for Children, Parel, Bombay.

Indian Pediatrics
|June 1, 1992
PubMed
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Neonatal gastrointestinal perforation requires prompt surgical intervention. Early detection and management are crucial for improving survival rates in these vulnerable infants.

Area of Science:

  • Neonatal surgery
  • Pediatric gastroenterology
  • Surgical critical care

Background:

  • Gastrointestinal perforation is a serious condition in neonates.
  • Understanding predisposing factors and outcomes is vital for clinical practice.

Purpose of the Study:

  • To analyze the clinical presentation, management, and outcomes of neonatal gastrointestinal perforation.
  • To identify factors associated with mortality and discuss preventative strategies.

Main Methods:

  • Retrospective review of 14 neonates with gastrointestinal perforation.
  • Analysis of clinical data, operative findings, microbiological cultures, and patient outcomes.
  • Correlation of mortality with white blood cell count and peritoneal culture results.

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Main Results:

  • 13 of 14 neonates underwent operative intervention for gastrointestinal perforation.
  • Common sites included gastric, ileal, cecal, and sigmoid colon perforations.
  • Klebsiella was the predominant organism in positive peritoneal cultures, particularly in non-survivors.

Conclusions:

  • Early surgical intervention is critical for improving survival in neonatal gastrointestinal perforation.
  • Judicious use of invasive catheters (umbilical, gastric, rectal) may reduce perforation risk.
  • High white blood cell counts and Klebsiella infections are associated with increased mortality.