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Etiology of neonatal gastric perforation: a review of 20 years’ experience

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Abstract

Purpose

Gastric perforation (GP) of the newborn is a rare, serious, and life-threatening problem, and its etiology remains unclear. Although historically GP has often been described as “spontaneous’’, some cases are non-spontaneous. The aim of the present study was to review cases of GP and to discuss its etiology in a single prefecture in Japan over a period of 20 years.

Methods

Eleven cases with GP that underwent surgery in 4 institutions in the Chiba Prefecture from 1991 to 2010 were reviewed and divided into 2 groups: the early (1991–2000, n = 7) and late (2001–2010, n = 4) groups.

Results

No factors were observed that could have caused GP other than malformations associated with distal obstruction (3 midgut volvulus, 1 jejunal stenosis, 1 diaphragm eventration). Distal obstruction was present in 1 case in the early group and all 4 cases in the late group (p = 0.015). While the incidence of GP did not change over the 20-year period reviewed, the incidence of GP without distal obstruction significantly decreased in the late group.

Conclusion

The proportion of patients with GP and distal obstruction increased and true “spontaneous” cases of GP decreased over time. The possible presence of distal obstruction should be evaluated during surgery for GP.

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Matsudo City Hospital Children’s Medical Center, 4005 Kamihongo, Matsudo, Chiba, 271-8511, Japan

    Keita Terui & Shugo Komatsu

  2. Department of Pediatric Surgery, Chiba Children’s Hospital, Chiba, Chiba, Japan

    Jun Iwai & Mitsuyuki Nakata

  3. Department of Pediatric Surgery, Kimitsu Central Hospital, Kisarazu, Chiba, Japan

    Shin-ichi Yamada & Ayako Takenouchi

  4. Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan

    Hideo Yoshida

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  1. Keita Terui
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  2. Jun Iwai
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  3. Shin-ichi Yamada
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  4. Ayako Takenouchi
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  5. Mitsuyuki Nakata
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  6. Shugo Komatsu
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Correspondence to Keita Terui.

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Terui, K., Iwai, J., Yamada, Si. et al. Etiology of neonatal gastric perforation: a review of 20 years’ experience. Pediatr Surg Int 28, 9–14 (2012). https://doi.org/10.1007/s00383-011-3003-4

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  • DOI: https://doi.org/10.1007/s00383-011-3003-4

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