NEONATAL GASTROINTESTINAL PERFORATIONS
A. Elhalaby, E., I. Eldesoky, N., H. Dawoud, H., F. Elsamongy, A., A. Darwish, A., A. Atia, M., Awny, M., E. Badwy, M. (2000). NEONATAL GASTROINTESTINAL PERFORATIONS. EKB Journal Management System, 19(2), 78-86. doi: 10.21608/ejsur.2000.378634
Essam A. Elhalaby; Nagy I. Eldesoky; Hamada H. Dawoud; Ahmed F. Elsamongy; Ahmed A. Darwish; Mohamed A. Atia; Moustafa Awny; Manal E. Badwy. "NEONATAL GASTROINTESTINAL PERFORATIONS". EKB Journal Management System, 19, 2, 2000, 78-86. doi: 10.21608/ejsur.2000.378634
A. Elhalaby, E., I. Eldesoky, N., H. Dawoud, H., F. Elsamongy, A., A. Darwish, A., A. Atia, M., Awny, M., E. Badwy, M. (2000). 'NEONATAL GASTROINTESTINAL PERFORATIONS', EKB Journal Management System, 19(2), pp. 78-86. doi: 10.21608/ejsur.2000.378634
A. Elhalaby, E., I. Eldesoky, N., H. Dawoud, H., F. Elsamongy, A., A. Darwish, A., A. Atia, M., Awny, M., E. Badwy, M. NEONATAL GASTROINTESTINAL PERFORATIONS. EKB Journal Management System, 2000; 19(2): 78-86. doi: 10.21608/ejsur.2000.378634

NEONATAL GASTROINTESTINAL PERFORATIONS

The Egyptian Journal of Surgery
Volume 19, Issue 2, April 2000, Page 78-86  XML PDF (950.29 K)
Document Type: Original Article
DOI: 10.21608/ejsur.2000.378634
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Authors
Essam A. Elhalaby* 1; Nagy I. Eldesoky1; Hamada H. Dawoud1; Ahmed F. Elsamongy2; Ahmed A. Darwish2; Mohamed A. Atia2; Moustafa Awny3; Manal E. Badwy4
1Departments of Pediatric Surgery, Tanta University Hospital, Tanta , Egypt
2Departments of Surgery, Tanta University Hospital, Tanta , Egypt
3Departments of Pediatric, Tanta University Hospital, Tanta , Egypt
4Departments of Radiology, Tanta University Hospital, Tanta , Egypt
Abstract
Purpose: Neonatal gastrointestinal perforations continue to be associated with high morbidity and mortality rates. The
aim of this study was to define causes, risk factors, and management of neonatal gastrointestinal perforations; and to
analyze factors relevant to outcome.
Methods: The medical records of 45 neonates treated at Tanta University Hospital for gastrointestinal perforations
during the last 6 years were retrospectively reviewed.
Results: Forty-five infants (25 males and 20 females) were analyzed. Their birth weight ranged from 1100 to 3500 grams
(mean 2200 ± 750 grams). Perforations occurred from birth to 26 days (mean 10.5 days). Main causes of perforations included necrotizing enterocolitis (NEC) (21, 46.7%), spontaneous gastroduodenal perforation (5, 11%), iatrogenic colorectal perforations (4, 8.8%), spontaneous intestinal perforations (3, 6.6%), Hirschsprung’s disease (2, 4.4%), and meconium ileus (2, 4.4%). The terminal ileum and cecum were the most frequent sites of perforation. All patients underwent laparotmy except one patient, who died prior to surgical intervention. There were 19 deaths (42.2%). Nearly half of deaths (9, 47.4%) occurred in infants with NEC.
Conclusions: 1: Septicemia, low birth weight, prematurity and delayed recognition of perforation were responsible for
the majority of deaths in our series; 2: Although the overall mortality in this series compares favorably with similar other
large series in the literature, there is still a room for improvement should iatrogenic perforations and delay in diagnosis be avoided: and 3: Simple closure for isolated perforations or resection and primary anastomosis is the treatment of choice, however, creation of stoma in some instances may be warranted.
Keywords
Gastrointestinal perforations; necrotizing enterocolitis; Neonatal peritonitis
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