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Subtotal gastrectomy in infancy for perforating necrotizing gastritis
R Bilik1, N Freud, T Sheinfeld
1Department of Pediatric Surgery, Beilinson Medical Center, Petah-Tikva, Israel.
Journal of Pediatric Surgery
|December 1, 1990
Summary
Necrotizing gastritis is a rare infant condition. This case highlights the diagnostic challenges of posterior gastric perforation, emphasizing the need for prompt surgical intervention in infants with severe symptoms.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Neonatal Pathology
Background:
- Necrotizing gastritis is a critical condition in infants, associated with significant morbidity and mortality.
- Early diagnosis and intervention are crucial for improving outcomes in affected neonates.
Observation:
- A 4-week-old infant with congenital anomalies (hypoplastic kidney, ectopic ureter) presented with septic shock and "coffee ground" vomitus.
- Clinical deterioration included the development of ascites and radiographic evidence of free air in the abdomen.
Findings:
- Exploratory laparotomy revealed double posterior gastric wall perforations and extensive gastric necrosis.
- Subtotal gastrectomy was required to manage the severe gastric damage.
Implications:
- This case underscores the diagnostic difficulties associated with posterior gastric perforation into the lesser sac.
- Prompt surgical management is essential for necrotizing gastritis and gastric perforations in infants.