The pattern of neonatal gastro-intestinal perforation in upper Egypt

Nezar Abd Elrouf Abo-Halawa,Mohamed Ahmed Negm,Mohamed Fathy

doi:10.1186/s43159-020-00029-9

Nezar Abd Elrouf Abo-Halawa, Mohamed Ahmed Negm + Show 1 more

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https://doi.org/10.1186/s43159-020-00029-9

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Abstract

BackgroundNeonatal gastro-intestinal perforation [NGIP] is one of the major problems in pediatric surgical practice. Although the outcomes of neonatal surgery have improved markedly over the past decade the mortality rates of neonates with NGIP are still high. The aim of this study was to present the possible etiological factors, clinical findings, and operative procedures of NIP in our locality.ResultsA total of 34 neonates with NGIP were included in this study. The median age at presentation was (15.8 ± 7.0 SD) days. The median interval between presentation and surgical interference was (2.0 ± 1.1 SD).Necrotizing enterocolitis [NEC] was the commonest cause of neonatal gastro-intestinal perforation. The commonest site of perforation was the colon [11cases]. The overall mortality rate was 11 cases [32.4%]. The main cause of mortality was neonatal NEC [6 cases]. Eight cases [40 %] died out of 20 cases which the interval between the presentation and interference were more than one day.ConclusionsNeonatal gastro-intestinal perforations are still associated with high mortality rate in our institutions, and delayed diagnosis with increased interval between the presentation and surgical intervention are associated with increased mortality. In our locality, although NEC is the commonest cause of NGIP, the iatrogenic cause is relatively higher than reported.

Highlights

Neonatal gastro-intestinal perforation [NGIP] is one of the major problems in pediatric surgical practice
The aim of this study was to present our experience of NGIP as the possible etiological factors, clinical findings and operative procedures in our locality at Upper Egypt
We sought to investigate the relationship between the demographic characteristics data [gestational age, birth weight, the age of presentation and sex] as well as operative findings with prognosis and survival rate of NIP

Summary

Introduction

Neonatal gastro-intestinal perforation [NGIP] is one of the major problems in pediatric surgical practice. The outcomes of neonatal surgery have been improved markedly over the past decade due to the development of neonatal intensive management and care, as ventilator care, better surgical, and anesthetic techniques such as ventilator management, operative, and anesthetic techniques, the mortality rates of neonates with NIP are still high, ranging from 15 to 70% This mortality depends on some causes such as birth weight, number of perforation, and delayed presentation [3,4,5,6,7,8,9,10]. We sought to investigate the relationship between the demographic characteristics data [gestational age, birth weight, the age of presentation and sex] as well as operative findings (causes of NGIP, sites, numbers of perforation and operative procedures done) with prognosis and survival rate of NIP The identification of this relationship may enable early intervention, possibly leading to improved outcomes

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