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Abdominal foregut perforations in children: a 10-year experience
Janet Abadir1, Sherif Emil, Nam Nguyen
1Division of Pediatric Surgery, Department of Surgery, University of California, Irvine Children's Hospital, Orange, CA 92868-3298, USA.
Journal of Pediatric Surgery
|December 13, 2005
Summary
Pediatric intraabdominal foregut perforations are rare, often occurring in neonates and associated with comorbidities. Primary repair offers excellent long-term outcomes for survivors of these gastric, esophageal, or duodenal injuries.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Intraabdominal foregut perforations in children are uncommon occurrences.
- These perforations can arise from various causes, impacting the esophagus, stomach, or duodenum.
Purpose of the Study:
- To investigate the etiologies, treatment strategies, patient outcomes, and prognosis of intraabdominal foregut perforations in pediatric patients.
- To identify risk factors and potential preventative measures for these rare events.
Main Methods:
- A retrospective review of pediatric patients treated for abdominal foregut perforations over a 10-year period.
- Exclusion of perforations due to trauma or intraoperative mishaps.
Main Results:
- Fourteen perforations were identified (1 esophageal, 8 gastric, 5 duodenal), with 50% occurring in neonates.
- Comorbidities were present in 64% of patients; 43% of perforations were spontaneous, 36% iatrogenic.
- Primary repair was performed in 79% of cases, with a survival rate of 86% to discharge and excellent long-term oral feeding for survivors.
Conclusions:
- Pediatric abdominal foregut perforations have varied causes, frequently affecting neonates and often associated with significant comorbidities.
- Iatrogenic causes represent a substantial portion and may be preventable.
- Primary repair is recommended when feasible, leading to favorable long-term outcomes for surviving patients.
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