Abstract
Ten neonates ranging in gestational age from 27 to 40 weeks and weighing 800–3,000 g presented, nine with peritonitis and pneumoperitoneum and one with gastroschisis. At surgery, perforation and rupture of the stomach was discovered. One had a tracheo-oesophageal fistula, one had gastroschisis, and in nine cases there had either been endotracheal intubation and mechanical ventilation or bag-and-mask ventilation and nasogastric intubation. Four patients died. While no cause for the perforation was identified, it is proposed that care in the respiratory resuscitation of neonates and premature infants is essential to prevent the problems of gastric perforation.
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References
Bayatpour M, Bernard L, McCune F, Bariel WI (1979) Spontaneous gastric rupture in the newborn. Am J Surg 137: 267–269
Bell MJ (1985) Perforation of the gastrointestinal tract and peritonitis in the newborn. Surg Gynecol Obstet 160: 20–26
Field D, Milner AD, Hopkin IE, (1986) Efficiency of manual resuscitators at birth. Arch Dis Child 61: 300–302
Gullois B, Parent P, Gaudin J, Jehannin B, Alix D (1987) Neonatal gastric perforation in twins. Pediatr Surg Int 2: 255–256
Gupta M, Brands YW (1978) Gastric retention in neonates. Pediatrics 62: 26–29
Hoskyns EW, Milner AD, Hopkin IE (1987) A simple method of face mask resuscitation at birth. Arch Dis Child 62: 376–378
Hoskyns EW, Milner AD, Boon AW, Vyas H, Hopkin IE, (1987) Endotracheal resuscitation of preterm infants at birth. Arch Dis Child 62: 663–666
Houck WS Jr, Griffin JA (1981) Spontaneous linear tears of the stomach in the newborn infant. Ann. Surg., 193: 763–768
Jones TB, Kirchner SG, Lee FA, Heller RM (1980) Stomach rupture in association with esophageal atresia, tracheoesophageal fistula and ventilatory assistance. AJR Am J Roentgenol 134: 675–677
Krause S, Donen N (1984) Gastric rupture during cardiopulmonary resuscitation. Can Anaesth Soc J, 31: 319–322
Linch D, McDonald A, McNicol L (1979) Tension pneumoperitoneum complicating cardiac resuscitation. Intensive Care Med, 5: 93–94
Marrie V, Moosa A, Cywes S, (1978) Gastric perforation in the newborn. S Afr Med J 54: 202–204
Milner AD, Vyas H, Hopkin IE (1984) Efficacy of face mask resuscitation at birth. Br Med J 289: 1563–1565
Quak SH, Joseph VT, Wong HB (1984) Neonatal total gastrectomy. Clin Pediatr 23: 507–509
Rimmer DG (1966) Gastric distension without mechanical obstruction. Arch Int Med 117: 287–299
Rosser SB, Clark CH, Elechi EN (1982) Spontaneous neonatal gastric perforation. J Pediatr Surg 17: 390–394
Shaker IJ, Schaffer JA, James AE, White JJ (1973) Aerophagia: a mechanism for spontaneous rupture of the stomach. Am Surg 39: 619–623
Tan CEL, Keily EM, Agrawal M, Brereton RJ, Spitz L (1989) Neonatal gastrointestinal perforation. J Pediatr Surg 24: 888–892
Tessler S, Kupfer Y, Lerman A, Arsura EL (1990) Massive gastric distension in the intubated patient. Arch Int Med 150: 318–320
Touloikian RJ (1973) Gastric ischaemia: the primary factor in neonatal perforation. Clin Pediatr (Phila) 12: 219–225
Touloikian RJ, Posch JN, Spencer R (1977) The pathogenesis of ischemic gastroenterocolitis of asphyxiated neonatal piglets. J Pediatr Surg 7: 194–196
Vyas H, Milner AD, Hopkin IE (1983) Face mask resuscitation: does it lead to gastric distention? Arch Dis Child 58: 373–375
Woon KY, Tock EPC, Tan KL (1978) Spontaneous rupture of the stomach in the neonatal. J Singapore Pediatr Soc 20: 93–96
Zamir O, Goldberg M, Udassin R, Peleg O, Nissan S, Eyal F (1988) Idiopathic gastrointestinal perforation in the neonate. J Pediatr Surg 23: 335–337
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Bruce, J., Bianchi, A., Doig, C.M. et al. Gastric perforation in the neonate. Pediatr Surg Int 8, 17–19 (1993). https://doi.org/10.1007/BF02352993
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DOI: https://doi.org/10.1007/BF02352993