Neonatal gastrointestinal perforation is a major challenge; A retrospective study

Abstract

Ahmed Elrouby

Objectives: The objective of our study was to study the outcome of the perforated gut in the neonatal age group in our institute in relation to the personal data (age, sex), the operative details (abdominal incision, peritonitis &collection, the type of the performed procedure, the type, site and cause of the perforation) and the length of the hospital stay. Material and methods: The records of all neonates with perforated gut, who were admitted to the Pediatric Surgery Department, Faculty of Medicine, Alexandria University, between January 2015 and November 2017 were retrospectively reviewed. The personal data (age, sex), the operative details (abdominal incision, peritonitis &collection, the type of the performed procedure, the type, site, and cause of the perforation) and the length of the hospital stay were collected and analyzed. All of the previously enumerated factors were correlated to the final outcome of the patients. Patients with incom-plete data were excluded from our study.Results: Our study included 44 neonates; all of them were under one month old. The patients were divided into three groups (A, B, and C) according to their final outcome. Patients of group A were those who had been discharged after surgical exploration, patients of group B were those who died after surgical exploration and patients of group C who died before any surgical exploration. So the actual mortality rate in our study, including both patients of group B and group C (18 patient) was 40%. Sealed perforation was found in 2 patients, solitary perforation in 28 patients and only nine patients had multiple perforations. Nothing had been done for the two patients with sealed perforation; however, four patients had direct closure of their perforated loop, three patients had resection anastomosis of the perforated loop, and 31 patients had a stoma. Birth weight, prematurity, and the amount of peritoneal collection were the only factors which had a statistically significant effect on the fate of our studied patients.Conclusion: Neonatal perforated gut had a high mortality rate which could be affected by birth weight, prematurity and the amount of peritoneal collection

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