Neonatal gastrointestinal perforations
Neonatal gastrointestinal perforation has been associated with mortality rates of 40% to 70%. Over the past 20 years, 81 infants (46 boys and 35 girls) were treated for a gastrointestinal perforation at this institution. Perforation occurred from birth to 50 days (average, 8.2 days). Etiologies incl...
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| Veröffentlicht in: | Journal of pediatric surgery 1992-10, Vol.27 (10), p.1340-1342 |
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| container_title | Journal of pediatric surgery |
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| creator | St-Vil, Dickens LeBouthillier, Guy Luks, François I. Bensoussan, AriéL. Blanchard, Hervé Youssef, Sami |
| description | Neonatal gastrointestinal perforation has been associated with mortality rates of 40% to 70%. Over the past 20 years, 81 infants (46 boys and 35 girls) were treated for a gastrointestinal perforation at this institution. Perforation occurred from birth to 50 days (average, 8.2 days). Etiologies included necrotizing enterocolitis (NEC) (68%), meconium ileus (10%), and idiopathic gastric perforation (7%). Seventy-six infants underwent surgical exploration and five infants, considered too small or too sick to withstand a laparotomy, were treated with peritoneal lavage only. There were 29 deaths, an overall mortality of 36%. Ninety percent of the death occurred in patients with NEC, while all patients with gastric perforations survived. There has not been a significant improvement in survival in recent years, partly because of an increase in the proportion of NEC-related perforations. However, there is a narrowing of the mortality gap between low birth weight and normal weight infants. As the risk inherent to laparotomy in neonates is decreasing, other factors, such as the underlying etiology or the site of perforation, play a more important prognostic role. |
| doi_str_mv | 10.1016/0022-3468(92)90292-F |
| format | Article |
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Over the past 20 years, 81 infants (46 boys and 35 girls) were treated for a gastrointestinal perforation at this institution. Perforation occurred from birth to 50 days (average, 8.2 days). Etiologies included necrotizing enterocolitis (NEC) (68%), meconium ileus (10%), and idiopathic gastric perforation (7%). Seventy-six infants underwent surgical exploration and five infants, considered too small or too sick to withstand a laparotomy, were treated with peritoneal lavage only. There were 29 deaths, an overall mortality of 36%. Ninety percent of the death occurred in patients with NEC, while all patients with gastric perforations survived. There has not been a significant improvement in survival in recent years, partly because of an increase in the proportion of NEC-related perforations. However, there is a narrowing of the mortality gap between low birth weight and normal weight infants. As the risk inherent to laparotomy in neonates is decreasing, other factors, such as the underlying etiology or the site of perforation, play a more important prognostic role.</description><identifier>ISSN: 0022-3468</identifier><identifier>EISSN: 1531-5037</identifier><identifier>DOI: 10.1016/0022-3468(92)90292-F</identifier><identifier>PMID: 1403517</identifier><identifier>CODEN: JPDSA3</identifier><language>eng</language><publisher>Philadelphia, PA: Elsevier Inc</publisher><subject>Biological and medical sciences ; Enterocolitis, Pseudomembranous - complications ; Enterocolitis, Pseudomembranous - mortality ; Enterocolitis, Pseudomembranous - surgery ; Female ; Follow-Up Studies ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Infant, Newborn ; Infant, Premature, Diseases - etiology ; Infant, Premature, Diseases - mortality ; Infant, Premature, Diseases - surgery ; Intestinal Obstruction - complications ; Intestinal Obstruction - mortality ; Intestinal Obstruction - surgery ; Intestinal Perforation - congenital ; Intestinal Perforation - mortality ; Intestinal Perforation - surgery ; Male ; Meconium ; Medical sciences ; Other diseases. Semiology ; Retrospective Studies ; Stomach Rupture - complications ; Stomach Rupture - mortality ; Stomach Rupture - surgery ; Stomach. Duodenum. Small intestine. Colon. Rectum. 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Over the past 20 years, 81 infants (46 boys and 35 girls) were treated for a gastrointestinal perforation at this institution. Perforation occurred from birth to 50 days (average, 8.2 days). Etiologies included necrotizing enterocolitis (NEC) (68%), meconium ileus (10%), and idiopathic gastric perforation (7%). Seventy-six infants underwent surgical exploration and five infants, considered too small or too sick to withstand a laparotomy, were treated with peritoneal lavage only. There were 29 deaths, an overall mortality of 36%. Ninety percent of the death occurred in patients with NEC, while all patients with gastric perforations survived. There has not been a significant improvement in survival in recent years, partly because of an increase in the proportion of NEC-related perforations. However, there is a narrowing of the mortality gap between low birth weight and normal weight infants. As the risk inherent to laparotomy in neonates is decreasing, other factors, such as the underlying etiology or the site of perforation, play a more important prognostic role.</description><subject>Biological and medical sciences</subject><subject>Enterocolitis, Pseudomembranous - complications</subject><subject>Enterocolitis, Pseudomembranous - mortality</subject><subject>Enterocolitis, Pseudomembranous - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Premature, Diseases - etiology</subject><subject>Infant, Premature, Diseases - mortality</subject><subject>Infant, Premature, Diseases - surgery</subject><subject>Intestinal Obstruction - complications</subject><subject>Intestinal Obstruction - mortality</subject><subject>Intestinal Obstruction - surgery</subject><subject>Intestinal Perforation - congenital</subject><subject>Intestinal Perforation - mortality</subject><subject>Intestinal Perforation - surgery</subject><subject>Male</subject><subject>Meconium</subject><subject>Medical sciences</subject><subject>Other diseases. Semiology</subject><subject>Retrospective Studies</subject><subject>Stomach Rupture - complications</subject><subject>Stomach Rupture - mortality</subject><subject>Stomach Rupture - surgery</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Survival Rate</subject><issn>0022-3468</issn><issn>1531-5037</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9LAzEQxYMotVa_gYIHKXpYzZ9NsrkIUqwKRS96DtnsRCLbTU22gt_e1C315mngze8N8x5CpwRfE0zEDcaUFqwU1aWiVwpTRYv5HhoTzkjBMZP7aLxDDtFRSh8YZxmTERqREjNO5BhNnyF0pjft-btJfQy-6yH1vsvCCqIL0fQ-dOkYHTjTJjjZzgl6m9-_zh6LxcvD0-xuUVhWib7g3GBTCQGqlI7WjtEGLCjuuGhkzQhhjivKeSVKKa2AkkhGnKsZ1FKqRrEJmg53VzF8rvMneumThbY1HYR10pJRRrBgGSwH0MaQUgSnV9EvTfzWBOtNPXqTXW-ya0X1bz16nm1n2_vregnNn2noI-8vtnuTrGldNJ31aYeVHKuKVhm7HTDIXXx5iDpZD52FxkewvW6C__-PH31pf5c</recordid><startdate>19921001</startdate><enddate>19921001</enddate><creator>St-Vil, Dickens</creator><creator>LeBouthillier, Guy</creator><creator>Luks, François I.</creator><creator>Bensoussan, AriéL.</creator><creator>Blanchard, Hervé</creator><creator>Youssef, Sami</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19921001</creationdate><title>Neonatal gastrointestinal perforations</title><author>St-Vil, Dickens ; LeBouthillier, Guy ; Luks, François I. ; Bensoussan, AriéL. ; Blanchard, Hervé ; Youssef, Sami</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-55a0a866e947f2bf32dece95f56d7b3113f5925586477c6e41731ffb3eb779d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Biological and medical sciences</topic><topic>Enterocolitis, Pseudomembranous - complications</topic><topic>Enterocolitis, Pseudomembranous - mortality</topic><topic>Enterocolitis, Pseudomembranous - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature, Diseases - etiology</topic><topic>Infant, Premature, Diseases - mortality</topic><topic>Infant, Premature, Diseases - surgery</topic><topic>Intestinal Obstruction - complications</topic><topic>Intestinal Obstruction - mortality</topic><topic>Intestinal Obstruction - surgery</topic><topic>Intestinal Perforation - congenital</topic><topic>Intestinal Perforation - mortality</topic><topic>Intestinal Perforation - surgery</topic><topic>Male</topic><topic>Meconium</topic><topic>Medical sciences</topic><topic>Other diseases. Semiology</topic><topic>Retrospective Studies</topic><topic>Stomach Rupture - complications</topic><topic>Stomach Rupture - mortality</topic><topic>Stomach Rupture - surgery</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>St-Vil, Dickens</creatorcontrib><creatorcontrib>LeBouthillier, Guy</creatorcontrib><creatorcontrib>Luks, François I.</creatorcontrib><creatorcontrib>Bensoussan, AriéL.</creatorcontrib><creatorcontrib>Blanchard, Hervé</creatorcontrib><creatorcontrib>Youssef, Sami</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>St-Vil, Dickens</au><au>LeBouthillier, Guy</au><au>Luks, François I.</au><au>Bensoussan, AriéL.</au><au>Blanchard, Hervé</au><au>Youssef, Sami</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neonatal gastrointestinal perforations</atitle><jtitle>Journal of pediatric surgery</jtitle><addtitle>J Pediatr Surg</addtitle><date>1992-10-01</date><risdate>1992</risdate><volume>27</volume><issue>10</issue><spage>1340</spage><epage>1342</epage><pages>1340-1342</pages><issn>0022-3468</issn><eissn>1531-5037</eissn><coden>JPDSA3</coden><abstract>Neonatal gastrointestinal perforation has been associated with mortality rates of 40% to 70%. Over the past 20 years, 81 infants (46 boys and 35 girls) were treated for a gastrointestinal perforation at this institution. Perforation occurred from birth to 50 days (average, 8.2 days). Etiologies included necrotizing enterocolitis (NEC) (68%), meconium ileus (10%), and idiopathic gastric perforation (7%). Seventy-six infants underwent surgical exploration and five infants, considered too small or too sick to withstand a laparotomy, were treated with peritoneal lavage only. There were 29 deaths, an overall mortality of 36%. Ninety percent of the death occurred in patients with NEC, while all patients with gastric perforations survived. There has not been a significant improvement in survival in recent years, partly because of an increase in the proportion of NEC-related perforations. However, there is a narrowing of the mortality gap between low birth weight and normal weight infants. As the risk inherent to laparotomy in neonates is decreasing, other factors, such as the underlying etiology or the site of perforation, play a more important prognostic role.</abstract><cop>Philadelphia, PA</cop><pub>Elsevier Inc</pub><pmid>1403517</pmid><doi>10.1016/0022-3468(92)90292-F</doi><tpages>3</tpages></addata></record> |
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| subjects | Biological and medical sciences Enterocolitis, Pseudomembranous - complications Enterocolitis, Pseudomembranous - mortality Enterocolitis, Pseudomembranous - surgery Female Follow-Up Studies Gastroenterology. Liver. Pancreas. Abdomen Humans Infant, Newborn Infant, Premature, Diseases - etiology Infant, Premature, Diseases - mortality Infant, Premature, Diseases - surgery Intestinal Obstruction - complications Intestinal Obstruction - mortality Intestinal Obstruction - surgery Intestinal Perforation - congenital Intestinal Perforation - mortality Intestinal Perforation - surgery Male Meconium Medical sciences Other diseases. Semiology Retrospective Studies Stomach Rupture - complications Stomach Rupture - mortality Stomach Rupture - surgery Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Survival Rate |
| title | Neonatal gastrointestinal perforations |
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