Necrosis and perforation of the stomach in newborn babies and infants
https://doi.org/10.24884/0042-4625-2020-179-5-36-40
Abstract
The Objective of the study was to identify the clinical features of newborns and infants with perforation of the stomach, and to justify the possibility of organ-preserving operations even with extensive gastric necrosis.
Methods and Materials. The results of treatment of 32 newborns with stomach perforation was analyzed: not only the risk factors that cause this condition, but diagnostic methods and variants of surgical treatment. All patients with extensive necrosis of the stomach wall underwent an atypical resection within healthy tissues, a gastric «tube» was formed on the drainage probe with a significant decrease of organ volume. In cases of the local damage of the gastric wall, the perforated area was sutured after the excision of the edges of the defect.
Results. Mortality rate was 36.5 % (n = 12). The cause of death in 5 children (15 %), in 3 to 8 days after surgery, was multiple organ failure syndrome. In 7 patients (22 %), a fatal outcome occurred due to the severe post-intensive care syndrome at the age of 3 to 12 months of life.
Conclusion. The mechanism of perforations of the stomach in newborns and infants is multifactorial. All children with stomach perforation need preoperative preparation. The operation of choice for the stomach perforation is an organpreserving surgery. The function of the stomach is restored in all children after extensive resection of the stomach.
About the Authors
S. A. Karavaeva
North-West State Medical University named after I. I. Mechnikov;
Children’s city multidisciplinary clinical specialized center for medical high technologies
Russian Federation
Russian Federation
Dr. of Sci. (Med.), Professor, Head of the Department of Pediatric Surgery;
Neonatologist Surgeon,
Saint Petersburg
A. V. Podkamenev
Saint-Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
Dr. of Sci. (Med.), Chief Non-staff Pediatric Surgeon of the Ministry of Health of the Russian Federation, Professor of the Department of Surgical Diseases of Childhood,
Saint Petersburg
A. A. Skopetc
North-West State Medical University named after I. I. Mechnikov;
Children’s city multidisciplinary clinical specialized center for medical high technologies
Russian Federation
Russian Federation
Postgraduate Student of the Department of Pediatric Surgery,
Saint Petersburg
References
1. Graivier L., Rundell K., McWilliams N., Carruth D. Neonatal Gastric Perforation and Necrosis: Ninety-Five Per Cent Gastrectomy and Colonic Interposition, with Survival. Annals of Surgery Med. J. 1973;177(4): 428–431.
2. Kozlov Yu. A. Novojilova V. A., Razumovskii A. Yu. Khirurgicheskie bolezni nedonoshennih detei. Nacionalnoe rukovodstvo. Moscow, GEOTARMedia, 2019:592. (In Russ.).
3. Sato M., Hamada Y., Kohno M., Ise K., Uchida K., Ogata H., Masuyama H., Morotomi Y., Yasufuku M., Wada M. Neonatal gastrointestinal perforation in Japan: a nationwide survey. Pediatr. Surg. Int. 2017;33(1): 33–41.
4. Gumerov A. A., Bayazitov R. R., Neudachin A. E., Latypova G. G., Novozhenina D. S. Perforatsiya zheludka u novorozhdennykh. Meditsinskiy vestnik Bashkortostana. 2018;13(4(76)):53–66. (In Russ.).
5. Durham M. M., Ricketts R. R. Neonatal gastric perforation and necrosis with Hunt-Lawrence pouch reconstruction. J. Pediatr. Surg. 1999;34(4):649–651.
6. Shabalov N. P. Detskaja gastrojenterologija. Rukovodstvo dlja vrachej. Moscow, MEDpress-inform, 2019:25–26. (In Russ.).
7. Simahodskij A. S., Kagan A. V., Novikova V. P et al. Metodologija ocenki fizicheskogo razvitija rebenka. Uchebnoe posobie. SPb., PSPbGMU, 2018:254. (In Russ.).
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For citations:
Karavaeva S.A., Podkamenev A.V., Skopetc A.A. Necrosis and perforation of the stomach in newborn babies and infants. Grekov's Bulletin of Surgery. 2020;179(5):36-40. (In Russ.) https://doi.org/10.24884/0042-4625-2020-179-5-36-40
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