Newborns with gastrointestinal system perforations: Report of thirty cases

Abstract

Thirty newborn with gastrointestinal system perforations were managed at Pediatric Surgery Department of Ondokuz Mayis University, Faculty of Medicine from July 1980 to December 1994. Of these cases; 19 were mature, seven were premature and four were small for gestational age. Twenty-nine of them underwent emergent surgery, but one patient died because of his general deterioration before surgical intervention. We could not find the cause of perforation in 11 cases and the place of perforation in one case. The perforation sites in our cases were stomach (7), colon (7) ileum (8), cecum (4), duodenum (1) and both the stomach and the ileum in one case. These perforations most commonly occurred in association with the pathologies of the wall or the lumen of the gut such as intestinal atresia (1), anorectal malformation (3), necrotizing enterocolitis (3), meconium ileus (3), and congenital aganglionic megacolon (2) and less commonly result of compressing factors outside the bowel such as Ladd's bands (2), omphlomesenteric band (3) and vascular anomaly of the mesentery (1). A prompt and an appropriate surgical intervention was carried out for each patient according to the place of perforation. The overall mortality was 48% and the mortality in stomach perforations was found to be less than ileal, cecal and colonic perforations. The cause of death was 60% sepsis.