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A rare case of multiple duodenal perforations in early infancy

Kiminobu Sugito1, Takeshi Kusafuka, Mikiya Inoue

  • 1Division of Pediatric Surgery, Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.

The Turkish Journal of Pediatrics
|March 28, 2008
PubMed

Insights

This case study details a premature infant experiencing duodenal perforation, likely from an ulcer. Surgical intervention was successful, with the infant showing normal growth post-operation.

Area of Science:

  • Neonatal surgery
  • Pediatric gastroenterology
  • Gastrointestinal pathology

Background:

  • Duodenal perforation is a rare neonatal emergency.
  • Premature infants, especially those with low birth weight and respiratory distress, are at increased risk.
  • Suspected peptic ulcer disease is a potential cause.

Observation:

  • A 26-week premature infant presented with abdominal distension 98 days after birth.
  • Radiographs confirmed massive pneumoperitoneum, indicating a perforated viscus.
  • Exploratory laparotomy revealed two duodenal perforations.

Findings:

  • The infant underwent direct closure of the perforations and intra-abdominal drainage.
  • Postoperative complications included central urorrhagia secondary to hematencephalon.
  • The patient achieved normal growth without duodenal ulcer recurrence.

Implications:

  • This case highlights the successful surgical management of duodenal perforation in a very premature infant.
  • Early diagnosis and surgical intervention are critical for favorable outcomes.
  • Further research into the etiology and prevention of neonatal duodenal ulcers is warranted.

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