Abstract
Neonatal gastric perforation (NGP) may be spontaneous, secondary to necrotizing enterocolitis (NEC), or due to distal obstruction. A 27-week old premature male newborn presented with pneumoperitoneum. A single perforation of stomach was found at surgery. Primary repair and gastrostomy were performed. On fifth postoperative day, pneumoperitoneum was again detected. At reoperation, multiple gastric perforations of the greater curvature were found. Sleeve gastrectomy was performed. The patient responded well to the treatment.
Highlights
A single gastric perforation of the posterior wall of the body of stomach was found which was managed with primary repair and gastrostomy
A sleeve gastrectomy was performed by initially identifying the pylorus of the stomach and the greater curve
Gastric perforation can be caused by increased gastric pressure by vigorous resuscitation and secondary to a big distal fistula in case of esophageal atresia with tracheoesophageal fistula, vigorous nasogastric tube insertion, distal obstruction, necrotizing enterocolitis (NEC), or spontaneous [1,2,3,4]
Summary
A premature 27-week old male, weighing 1110grams, born to a 28-year-old mother required orotracheal intubation for poor respiratory efforts owing to prematurity. In Neonatal ICU, the newborn had an episode of cardiac arrest which responded to cardiopulmonary resuscitation within a minute. Day enteral feeding was started but he developed gastric distension, and irritability. An orogastric tube was placed which drained bile.
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