Diagnostic Difficulties of Spontaneous Gastric Peforation in Adolescents

Year 2019, Volume: 1 Issue: 1, 7 - 10, 23.04.2019

Zeliha Akış Yıldız , Ceyhan Şahin , Mehmet Arpacık , Hayriye Nihan Ayyıldız Aytekin Kaymakçı

Abstract

Objective:
Spontaneous gastric
perforation (SGP) in adolescents is very rare. This study aims to evaluate the
diagnostic difficulties and misdiagnoses associated with SGP.

Methods: The medical records of patients that
underwent surgery for a gastric perforation over the past 2 years at our paediatric
surgery clinic were evaluated retrospectively. Patient demographics, symptoms,
diagnostic evaluation, diagnostic difficulties, operative findings, and post operative
clinical course were evaluated.

Results: Seven patients were identified as
having SGP. All of the patients were adolescents. Only 1 patient had a history
of gastritis; the other 6 patients did not have a history of any disease,
surgery or trauma. Radiological evidence of pneumoperitoneum using upright radiography
was only found in 1 patient (16.6%). One patient was misdiagnosed and thought to
have appendicitis. In 2 patients, the diagnosis was unclear, so diagnostic laparoscopy
was performed.

Conclusion:
SGP can be seen in
adolescents. However, sometimes it is difficult to diagnose. Even if all the
imaging studies and laboratory tests are normal, if there is a sign of
peritonitis upon physical examination, diagnostic laparoscopy could be
performed.

Keywords

gastric perforation, spontaneous gastric perforation

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