Related Experiment Video
Updated: Apr 11, 2026
Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers
Published on: July 28, 2022
Gastrointestinal perforation in neonates: aetiology and risk factors
Ekwunife Okechukwu Hyginus1, Ugwu Jideoffor1, Modekwe Victor1
1Paediatric Surgery Unit, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria.
Insights
Gastrointestinal perforation in neonates is often caused by necrotizing enterocolitis or obstruction, with delayed presentation and prematurity increasing mortality risk.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
- Surgical outcomes
Background:
- Gastrointestinal perforation (GIP) in neonates poses significant challenges with high mortality rates.
- This study reports recent experiences with neonatal GIP in a developing country context.
Purpose of the Study:
- To analyze the causes, management, and outcomes of neonatal GIP.
- To identify key risk factors for mortality in affected neonates.
Main Methods:
- Retrospective review of 16 neonates treated for GIP over a 3-year period.
- Data collected included patient demographics, presentation, diagnosis, surgical interventions, complications, and outcomes.
Main Results:
- Necrotizing enterocolitis (NEC) and intestinal obstruction were the most common causes of perforation.
- Delayed presentation ( >72 hours) occurred in 12 infants; prematurity was noted in 5.
- Surgical site infection was the most frequent complication; mortality was linked to NEC, multiple perforations, delayed presentation, and prematurity.
Conclusions:
- Neonatal GIP has diverse etiologies, with NEC being the leading cause.
- Factors such as NEC, multiple perforations, delayed presentation, and prematurity significantly increase mortality risk.
Background:
Gastrointestinal perforation (GIP) in neonates presents important challenges and mortality can be high. This is a report of recent experience with GIP in neonates in a developing country.
Patients And Methods:
A retrospective review of 16 neonates treated for GIP in a 3 year period.
Results:
There were 9 males and 7 females, aged 0-28 days (median age =7days). Their weights at presentation ranged from 0.9 - 4.7kg (median =2.6). Five infants were premature. Twelve infants presented more than 72 hours after onset of symptoms. Plain abdominal radiographs showed peumoperitoneum in 9 infants. The cause of perforation was necrotising enterocolitis 6, intestinal obstruction 6, iatrogenic 3 and spontaneous 1. The site of perforation was ileum in 12 infants, stomach in 4 and colon in 4; 4 patients had involvement of more than one site. All the neonates underwent exploratory laparotomy with primary closure ( n=5) , resection and anastomosis( n=6), colostomy (n=3), Ileostomy ( n=2), partial gastrectomy (n=2) ,or gastrojejunostomy ( n=1). Two neonates had multiple procedures. Two very sick preterm babies had an initial peritoneal lavage. Surgical site infection is the commonest postoperative complication occurring in 9 infants. Anaesthesia sepsis and malnutrition is responsible for the seven deaths recorded.
Conclusions:
Neonatal GIP has multiple aetiologies; NEC is the most common cause. Major mortality risk factors include NEC, multiple perforations, delayed presentation and prematurity.
Related Concept Videos
01:22Esophageal Perforation-I: Introduction
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:27Peptic Ulcer
01:30Esophageal Strictures-I: Introduction
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...