Kocaeli Med J. 2021; 10(3): 299-306 | DOI: 10.5505/ktd.2021.57124

Neonatal Gastric Perforation: A Single-Center Experience From 2002 to 2015

Fatih Kýlýçbay¹, Ayþe Engin Arýsoy², Mustafa Alper Akay³, Ayla Günlemez^2
1Division of Neonatology, Department of Pediatrics, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
²Division of Neonatology, Department of Pediatrics, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
³Department of Pediatrics Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Turkey

INTRODUCTION: Gastric perforation is a serious and life-threatening problem seen mostly in premature newborns in the neonatal period.Various causes play a role in the etiology.This retrospective study aimed to determine the etiology, basic risk factors, clinical features, prognosis, and mortality in newborns diagnosed with gastric perforation in our neonatal intensive care unit.
METHODS: Newborns diagnosed with gastric perforation between 2002 and 2015 were included in this study.Data including birth weight, gestational age,sex,risk factors,gastric perforation time,perforation location, and prognosis were recorded.
RESULTS: A total of eleven newborns diagnosed with gastric perforation were included in the study.The median gestational birth weight of the newborns was 2.014 g. Two of the newborns were term, and nine were preterm.Three of the newborns were female, and eight were male.The main clinical finding was abdominal distention, and pneumoperitoneum was detected in all newborns.The average age at diagnosis was 5.6 days.Spontaneous gastric perforation was detected in 6 newborns, and secondary gastric perforation was found in 5 newborns.Recurrent gastric perforation was detected in two newborns.The gastric perforation size was between 0.5 and 2.5 cm, and it was primarily detected in the greater curvature of the stomach.The absence of ýnterstitial cells of Cajal (ICC) was shown in a gastric muscle biopsy taken from a newborn.The mortality rate was 45%.
DISCUSSION AND CONCLUSION: Gastric perforation is an emergency that threatens the life of newborns.It can often develop due to distal obstruction or the absence of ICC cells.It is essential to look for ICC cells in the stomach muscle biopsy material to monitor for recurrent gastric perforation.

Keywords: gastric perforation, newborn, iInterstitial cells of Cajal

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Neonatal Gastrik Perforasyon: 2002'den 2015'e Tek Merkezde Bir Deneyim

Fatih Kýlýçbay¹, Ayþe Engin Arýsoy², Mustafa Alper Akay³, Ayla Günlemez^2
1Sivas Cumhuriyet Üniversitesi Týp Fakültesi, Çocuk Saðlýðý ve Hastalýklarý Anabilim Dalý, Neonatoloji Bilim Dalý, Sivas, Türkiye
²Kocaeli Üniversitesi Týp Fakültesi,Çocuk Saðlýðý ve Hastalýklarý Anabilim Dalý, Neonatoloji Bilim Dalý, Kocaeli Türkiye
³Kocaeli Üniversitesi Týp Fakültesi,Çocuk Cerrahisi Anabilim Dalý, Kocaeli Türkiye

GÝRÝÞ ve AMAÇ: Mide perforasyonu yenidoðan döneminde daha çok prematüre bebeklerde görülen ciddi ve hayatý tehdit eden bir sorundur. Etiyolojide çok çeþitli nedenler rol oynamaktadýr. Bu retrospektif çalýþmada, yenidoðan yoðun bakým ünitemizde mide perforasyonu tanýsý alan yenidoðanlarda etyolojiyi,temel risk faktörlerini, klinik özellikleri, prognozu ve mortaliteyi belirlemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Bu çalýþmaya 2002-2015 yýllarý arasýnda mide perforasyonu tanýsý alan yenidoðanlar dahil edildi.Doðum aðýrlýðý, gebelik yaþý, cinsiyet, risk faktörleri, mide delinme zamaný, perforasyon yeri ve prognozu içeren veriler kaydedildi.
BULGULAR: Mide perforasyonu tanýsý konulan 11 yenidoðan çalýþmaya dahil edildi. Yenidoðanlarýn medyan gestasyonel doðum aðýrlýðý 2.014 gr idi. Vakalarýn 2’ si term, 9'u preterm idi. Hastalarýn 3’ü kýz, 8 ‘i erkekti. Ana klinik bulgu abdominal distansiyondu ve tüm hastalarda pnömoperitoneum saptandý. Ortalama taný yaþý 5,6 gündü.Hastalarýn 6’sýnda spontan mide perforasyonu, 5'inde ise sekonder mide perforasyonu saptandý.Ýki hastada tekrarlayan mide perforasyonu tespit edildi. Mide perforasyonun boyutu 0,5-2,5 cm arasýnda idi ve daha çok midenin büyük kurvaturunda saptandý.Bir hastadan alýnan mide kasý biyopsisinde interstisyel Cajal hücresinin olmadýðý gösterildi.Ölüm oraný% 45 idi.
TARTIÞMA ve SONUÇ: Mide perforasyonu, yeni doðan bebeklerin hayatýný tehdit eden acil bir durumdur. Çoðunlukla distal obstrüksiyon veya interstisyel Cajal hücrelerinin yokluðuna baðlý olarak geliþebilir. Tekrarlayan mide perforasyonunu izlemek için mide kasý biyopsi materyalinde interstisyel Cajal hücrelerini aramak önemlidir.

Anahtar Kelimeler: mide delinmesi, yenidoðan, interstisyel cajal hücresi

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