Abstract
ofagus, mide ve duodenum perforasyonları yenidoğanlarda ve çocuklarda nadirdir. Çeşitli etyolojik faktörlerbildirilmiş olmasına rağmen, nedeni tam olarak belli değildir.Solunum sıkıntısı nedeniyle gözlem altına alınan ve hikayesinde mideye orogastrik sonda takılarak yüksekbasınçlı aspiratör ile mide aspirasyonu yapıldığı öğrenilen hasta, hayatının 2. gününde karında distansiyongelişmesi nedeni ile çekilen direk karın grafisinde serbest hava tespit edilmesi üzerine yatırılıp acilen operasyonaalındı. Operasyonda midenin arka yüzünde kardianın 3 cm aşağı seviyesinde büyük kurvatura 1 cm mesafede,kenarlarında noktasal tarzda kanama odakları olan perforasyon alanı tespit edilip primer sütür ile onarıldı. Hastasorunsuz olarak taburcu edildi.Yenidoğan ve prematürelerde herhangi bir sorun nedeniyle oro/nazogastrik sonda takılacak ve/veya aspirasyonyapılacaksa yumuşak sonda seçimi ve düşük basınçla aspirasyon yapılması gerektiği inancındayız
References
- 1. Richard J Leone, Irwin H. Krasna. 'Spontaneous' neonatal gastric perforation: is it really spontaneous? J Pediatr Surg 2000;35:1066-9.
- 2. Kara CS, Ilce Z, Celayir S, Sarimurat N, Erdogan E, Yeker D. Neonatal gastric perforation: review of 23 years' experience. Surg Today 2004;34:243-5.
- 3. Grosfeld JL, Molinari F, Pharm D, Chaet M, Engum SA, West KW, Rescrla FJ, Scherer III LR. Gastrointestinal perforation and peritonitis in ifants and children: Experience with 179 cases over ten years. Surgery 1996;120:650-6.
- 4. Dillon PW, Cilley RE. Lesions of the stomach, In: Ashcraft KW, Murphy PJ, Sharp RJ, Sigalet DL, Snyder CL, editors, Pediatric Surgery. W. B. Saunders, Philadelphia, Pennsylvania, 2000:391-05.
- 5. Pelizzo G, Dubois R, Lapillonne A, Laine X, Claris O, Bouvir R, Chappuis JP. Gastric necrosis in newborn: a report of 11 cases. Pediatr Surg Int 1998;13:346-9.
- 6. Abadir J, Emil S, Nguyen N. Abdominal foregut perforations in children: a 10-year experience. J Pediatr Surg 2005;40:1903-7.
- 7. Ohshiro K, Yamataka A, Kobayashi H, Hirai S, Miyahara K, Sueyoshi N, Suda K, Miyano T. Idiopathic gastric perforation in neonates and abnormal distribution of intestinal pacemaker cells. J Pediatr Surg. 2000;35:673-6.
- 8. Izraeli S, Freud E, Mor C. Neonatal intestinal perforation due to congenital defects. Eur J Pediatr 1992;151:300-3.
- 9. Connelly KP, Shropshire LC, Salzberg A. Gastric Rupture Associated with Prolonged Crying in a Newborn Undergoing Circumcision. Clinical Pediatrics 1992;31:560-1.
- 10. HouckWS, Griffin JA. Sponteaneous linear tears of the stomach in the newborn infant. Ann Surg 1981;193:763-8.
- 11. Shaker IJ, Schaffer JA, James AE. Aerophagia: a mechanism for spontaneous rupture of the stomach. Am Surg 1973;39:619-23.
Abstract
Perforations of the esophagus, stomach and duodenum are rarely encountered events in neonates and children. The etiology of gastric perforation in neonates is unclear at present, although various theories have been reported. Aneonate, admitted for respiratory distress to the neonatal intensive care unit was consulted by our Department of Pediatric Surgery for abdominal distention which developed in second day of his life. Postnatal history revealed utilization of high negative pressures during suctioning via administered orogastric tube. Due to free air determined at the abdominal x-ray, he was operated immediately. At the operation, a perforation area which had hemorrhagic spots at its borders at the posterior side of the stomach, three cm. below the cardia and at one cm. distance to the large curvature was seen and sutured primarily. Thereafter, the patient was discharged without any problems and with a complication-free followup. We believe that a soft catheter and low pressures should be used for neonates and premature newborns if orogastric catheter placement is necessary.
References
- 1. Richard J Leone, Irwin H. Krasna. 'Spontaneous' neonatal gastric perforation: is it really spontaneous? J Pediatr Surg 2000;35:1066-9.
- 2. Kara CS, Ilce Z, Celayir S, Sarimurat N, Erdogan E, Yeker D. Neonatal gastric perforation: review of 23 years' experience. Surg Today 2004;34:243-5.
- 3. Grosfeld JL, Molinari F, Pharm D, Chaet M, Engum SA, West KW, Rescrla FJ, Scherer III LR. Gastrointestinal perforation and peritonitis in ifants and children: Experience with 179 cases over ten years. Surgery 1996;120:650-6.
- 4. Dillon PW, Cilley RE. Lesions of the stomach, In: Ashcraft KW, Murphy PJ, Sharp RJ, Sigalet DL, Snyder CL, editors, Pediatric Surgery. W. B. Saunders, Philadelphia, Pennsylvania, 2000:391-05.
- 5. Pelizzo G, Dubois R, Lapillonne A, Laine X, Claris O, Bouvir R, Chappuis JP. Gastric necrosis in newborn: a report of 11 cases. Pediatr Surg Int 1998;13:346-9.
- 6. Abadir J, Emil S, Nguyen N. Abdominal foregut perforations in children: a 10-year experience. J Pediatr Surg 2005;40:1903-7.
- 7. Ohshiro K, Yamataka A, Kobayashi H, Hirai S, Miyahara K, Sueyoshi N, Suda K, Miyano T. Idiopathic gastric perforation in neonates and abnormal distribution of intestinal pacemaker cells. J Pediatr Surg. 2000;35:673-6.
- 8. Izraeli S, Freud E, Mor C. Neonatal intestinal perforation due to congenital defects. Eur J Pediatr 1992;151:300-3.
- 9. Connelly KP, Shropshire LC, Salzberg A. Gastric Rupture Associated with Prolonged Crying in a Newborn Undergoing Circumcision. Clinical Pediatrics 1992;31:560-1.
- 10. HouckWS, Griffin JA. Sponteaneous linear tears of the stomach in the newborn infant. Ann Surg 1981;193:763-8.
- 11. Shaker IJ, Schaffer JA, James AE. Aerophagia: a mechanism for spontaneous rupture of the stomach. Am Surg 1973;39:619-23.
Details
| Other ID | JA97FY38RB |
|---|---|
| Journal Section | Collection |
| Authors | |
| Publication Date | April 1, 2006 |
| Published in Issue | Year 2006 Volume: 7 Issue: 1 |