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[Gastrointestinal perforations in neonatal surgery].

G Benz1, H Roth, R Daum

  • 1Service de Chirurgie Infantile, CHU, Heidelberg.

Chirurgie Pediatrique
|January 1, 1987
PubMed
Summary

Gastro-intestinal perforations in newborns require immediate laparotomy. Despite intensive care, mortality remains high, especially in premature infants, necessitating prompt diagnosis and interdisciplinary treatment.

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Area of Science:

  • Neonatal surgery
  • Pediatric gastroenterology
  • Surgical critical care

Context:

  • Gastro-intestinal perforations present a significant challenge in neonatal care.
  • A retrospective analysis of 69 cases treated between 1970 and 1987.

Purpose:

  • To review clinical findings, diagnostic measures, and treatment outcomes for neonatal gastro-intestinal perforations.
  • To identify common causes, locations, and influencing factors on mortality.

Summary:

  • The most frequent perforation sites were the small bowel (58%) and colon (35%).
  • Etiologies included necrotizing enterocolitis (NEC), atresias, meconium ileus, Hirschsprung's disease, and iatrogenic causes.
  • The overall mortality rate was 33%, with over half of premature newborns succumbing.

Impact:

  • Highlights the persistent high mortality associated with neonatal gastro-intestinal perforations.
  • Emphasizes the need for rapid diagnosis, interdisciplinary collaboration, emergency surgery, and intensive care.
  • Suggests that advancements in surgical and intensive care can improve outcomes for previously unsalvageable cases.

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