Gastrointestinal Perforation in Neonates: Aetiology and Risk Factors

Authors

  • Hyginus Okechukwu Ekwunife Nnamdi Azikiwe University Teaching Hospital, Nnewi Anambra State Nigeria
  • Ugwu Jideoffor
  • Modekwe Victor
  • Osuigwe Andrew N

DOI:

https://doi.org/10.47338/jns.v2.42

Keywords:

Neonate, Intestine, Perforation, Aetiology

Abstract

Background: Gastrointestinal perforation (GIP) in neonates presents important challenges and mortality can be high. This is a report of recent experience with GIP in neonates in a developing country.

Patients and methods: A retrospective review of 16 neonates treated for GIP in a 3 year period.

Results: There were 9 males and 7 females, aged 0-28 days (median age =7days). Their weights at presentation ranged from 0.9 - 4.7kg (median =2.6). Five infants were premature. Twelve infants presented more than 72 hours after onset of symptoms. Plain abdominal radiographs showed peumoperitoneum in 9 infants. The cause of perforation was necrotising enterocolitis 6, intestinal obstruction 6, iatrogenic 3 and spontaneous 1. The site of perforation was ileum in 12 infants, stomach in 4 and colon in 4; 4 patients had involvement of more than one site. All the neonates underwent exploratory laparotomy with primary closure ( n=5) , resection and anastomosis( n=6), colostomy (n=3), Ileostomy ( n=2), partial gastrectomy (n=2) ,or gastrojejunostomy ( n=1). Two neonates had multiple procedures. Two very sick preterm babies had an initial peritoneal lavage. Surgical site infection is the commonest postoperative complication occurring in 9 infants. Anaesthesia sepsis and malnutrition is responsible for the seven deaths recorded.

Conclusions: Neonatal GIP has multiple aetiologies; NEC is the most common cause. Major mortality risk factors include NEC, multiple perforations, delayed presentation and prematurity.

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Author Biography

Hyginus Okechukwu Ekwunife, Nnamdi Azikiwe University Teaching Hospital, Nnewi Anambra State Nigeria

Surgery Department Nnamdi Azikiwe University Teaching Hospital, Nnewi Anambra State Nigeria

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Published

2013-06-29

How to Cite

1.
Ekwunife HO, Jideoffor U, Victor M, Andrew N O. Gastrointestinal Perforation in Neonates: Aetiology and Risk Factors. J Neonatal Surg [Internet]. 2013Jun.29 [cited 2021Feb.25];2(3):30. Available from: https://jneonatalsurg.com/ojs/index.php/jns/article/view/42