Neonatal gastrointestinal perforation in Japan: a nationwide survey.

Abstract

The purpose of this study is to identify the current clinical features of neonatal gastrointestinal perforation in Japan. A questionnaire about cases of neonatal gastrointestinal perforation treated in recent 5years was sent to participating institutions of the Japanese Society of Pediatric Surgeons (JSPS). Five hundred and thirty-six neonates with gastrointestinal perforation were treated. They consisted of 42 patients with gastric rupture/perforation (GR), 33 patients with intestinal atresia/stenosis (IA), 3 patients with malrotation (ML), 118 patients with necrotizing enterocolitis (NEC), 160 patients with focal intestinal perforation (FIP), 46 patients with meconium-related ileus (MRI), 77 patients with meconium peritonitis (MP), and 57 patients with other conditions. The total mortality rate was 20.5%. The mortality rates of the patients with GR, IA, ML, NEC, FIP, MRI, and MP were 9.5, 9.1, 0, 33.1, 20.6, 28.2, and 9.1%, respectively. In 263 cases involving extremely low-birth-weight neonates (ELBW), 108 died (mortality rate 41.1%). The mortality rates for ELBW with GR, NEC, FIP, MRI, MP, and other conditions were 27.3% (3/11), 58.5% (48/82), 21.6% (24/111), 70.6% (24/34), 57.1% (4/7), and 27.8% (5/18), respectively. The mortality rates for ELBW decreased from 62.8% in the previous survey to 41.1% by the time of this survey.