EN
TÜRKÇE
Poster - 20
Neonatal gastric perforation: a bi-centric study
M Salma*, K Nahla*, T Fatma**, B Nouha*, L Rachida*, K Amine*, M Mongi*, B Mohsen*, R Jouini**, L Sahnoun*
*Fattouma Bourguiba Hospital Monastir Tunisia
**children hospital Bechir Hamza, Pediatric surgery department A Tunis Tunisia
Neonatal gastric perforation (GP) is a rare and serious condition. It constitutes a neonatal surgical emergency. These facts prompted us to review observations of New born babies operated on for gastric perforation from 1990 to 2022.
Results:
Twenty-seven observations were described, a male predominance was found including 18 boys and 9 girls,
Risk factors included prematurity, hypotrophy, fetal or perinatal distress, twin pregnancies, gestational diabetes and maternal or obstetric anomalies. Lung maturation was performed in only one case and a retroperitoneal hematoma was found in one other case.
Birth weight ranged from 1200 to 3650g with an average of 2400 g.
GP is evoked in any new born presenting with abdominal distension associated or not with respiratory distress associated with pneumoperitoneum on standing unprepared abdominal film. Time to onset of symptoms ranged from 1 to 23 days, with an average of 5 days
Treatment is essentially surgical, with suturing of the edges with or without drainage. Gastrostomy was instaurated in 5 cases. In 25 cases the perforation was unique.
Fourteen new born survived with a good evolution after 3 years post operation.
Conclusion:
GP is a rare and serious entity. Several etiopathogenic hypotheses have been put forward: gastric ischemia, muscle defect, gastric distension and Cajal cell deficiency.
The prognosis of this condition remains poor, with a high mortality rate.
Pre- and postoperative neonatal resuscitation plays a key role in EP.