Gastric Perforation in the Neonatal Period: Differences between Preterm and Term Infants

ABSTRACT

PURPOSE: This study was performed to investigate the differences in gastric perforation in the neonatal period between preterm and term infants. METHODS: We retrospectively reviewed the medical records of neonates who underwent abdominal surgery between January 2005 and December 2014 at a single institution. Eleven neonates who were managed for gastric perforation were enrolled in this study. RESULTS: There were 8 preterm and 3 term neonates. In preterm neonates, the mean gestational age and birth weight were 29.7+/-3.7 weeks and 1,538.7+/-774.9 g, respectively. Two preterm neonates had very low birth weight and three had extremely low birth weight. In most of the preterm neonates, possible contributing factors were identified, such as maternal problems, mechanical ventilator support, and medication. In contrast, in term neonates, gastric perforation seemed to be associated with other gastrointestinal anomalies or occurred spontaneously. Two neonates died one preterm (12.5%) and one term (33.3%) neonate; both had a linear, necrotic perforation. CONCLUSION: Gastric perforation rarely occurred in the neonatal period. Contributing factors for gastric perforation were identified in preterm neonates, but this occurred spontaneously or with other gastrointestinal anomalies in term neonates. A linear, necrotic perforation was associated with poor outcomes, regardless of gestational age.