Neonatal gastrointestinal perforations

Neonatal gastrointestinal perforations continue to be associated with, high morbidity and mortality rates. The aim of this study was to define causes, risk factors, and management of neonatal gastrointestinal perforations; and to analyze factors relevant to outcome. The medical records of 45 neonates treated at Tanta University hospital for gastrointestinal perforations during the last 6 years were retrospectively reviewed. Forty-five infants [25 males and 20 females] were analyzed. Their birth weight ranged front 1100 to 3500 grams [mean 2200 +/- 750 grams]. Perforations occurred from birth to 26 days [mean 10.5 days]. Main causes of perforations included, necrotizing enterocolitis [NEC] [21, 46.7%], spontaneous gastroduodenal perforation [5, 11%], iatrogenic colorectal perforations [4, 8.8%], spontaneous intestinal perforations [3, 6.6%], Hirschsprung's disease [2, 4.4%], and meconium ileus [2, 4.4%]. The terminal ileum and cecum were the most frequent sites of perforation. All patients underwent laparotmy except one patient, who died prior to surgical intervention. There were 19 deaths [42.2%]. Nearly haIf of deaths [9, 47.4%] occurred in infants with NEC. 1 Septicemia, low birth weight, prematurity and delayed recognition of perforation were responsible for the majority of deaths in our series; 2: Although the overall mortality in this series compares favorably with similar other large series in the literature, there is still a root, for improvement should iatrogenic perforations and delay in diagnosis be avoided: and 3: Simple closure for isolated perforations or resection and primary anastomosis is the treatment of chronic, however, creation of stoma in some instances may be warranted