Neonatal gastric perforation in Twins: Two distinct cases


  • Sergey Alexandrovich Klyuev Saratov State Medical University n.a. V.I. Rasumovsky
  • Sergey Yurievich Gorodkov Department of Pediatric Surgery, Saratov State Medical University, Saratov, Russian Federation
  • Igor Vladimirovich Goremykin Department of Pediatric Surgery, Saratov State Medical University, Saratov, Russian Federation
  • Vyacheslav Germanovich Masevkin Department of Pediatric Surgery, Saratov State Medical University, Saratov, Russian Federation



Neonate, Stomach perforation, Necrotizing enterocolitis, Nasogastric tube


Background: Neonatal gastric perforation (NGP) is an uncommon but fatal condition. The exact cause of NGP remains unclear, although some cases have been linked to medical interventions. NGP is rarely reported in twins.

Case Presentation: Herein we report two cases of gastric perforation in twins. The first baby was one of the 34-week preterm twins that developed abdominal distension and respiratory distress on the third day of life. While the other baby was one of the 32-week preterm twins that too developed abdominal distension and respiratory distress. Both had gastric perforations that needed surgical repair. One baby died of sepsis while the other neonate had a stormy postoperative course, which was managed with meticulous monitoring and multidisciplinary management, and discharged in good clinical condition.

Conclusion: Clinical cases demonstrate that successful management of NGP requires a multidisciplinary approach, including timely surgical intervention, meticulous postoperative care, and close monitoring of complications.


Download data is not yet available.


Metrics Loading ...


Kim E. Gastric perforation in a newborn. J Pediatr Surg Case Rep. 2019; 43:87-89. Available from:

Huerta CT, Perez EA. Diagnosis and management of neonatal gastric perforation: a narrative review. Dig Med Res. 2022; 5:27. Available from:

Parasuraman D, Roy R, Mitchell S. Iatrogenic gastric perforation in a preterm infant: clinical presentation and radiological indicators. Internet J Pediatr Neonatol. 2006; 7(1).

Yang T, Huang Y, Li J. Neonatal gastric perforation: case series and literature review. World J Surg. 2018; 42:2668-73.

Sato M, Hamada Y, Kohno M, Ise K, Uchida K, Ogata H, et al. Neonatal gastrointestinal perforation in Japan: a nationwide survey. Pediatr Surg Int. 2017; 33:33-41. Available from:

Yang CY, Lien R, Fu RH, Chu SM, Hsu JF, Lai JY, et al. Prognostic factors and concomitant anomalies in neonatal gastric perforation. J Pediatr Surg. 2015 Aug;50(8):1278-82. Available from: https:// doi: 10.1016/j.jpedsurg.2015.04.007.

Huang Y, Lu Q, Peng N, Wang L, Song Y, Zhong Q, et al. Risk Factors for Mortality in Neonatal Gastric Perforation: A Retrospective Cohort Study. Front Pediatr. 2021 May 13;9:652139. Available from: https:// doi: 10.3389/fped.2021.652139.

Korai T, Kouchi K, Takenouchi A, Matsuoka A, Yabe K, Nakata C. Recurrent intestinal ischemia following surgery for gastric and duodenal perforations: a case report. Surg Case Rep. 2019; 5:124. Available from:

Klyuev SA, Goremykin IV, Masevkin VG, Gorodkov SY, Nikolaev AV, Shintaev TK, et al. Acute gastric dilation with necrosis: case report and literature review. J Clin Trials Exp Investig. 2022; 1:32-40. Available from:

Morozov DA, Morozova OL, Klyuev SA, Budnik IA, Maltseva LD, Morozov KD. Intra-abdominal hypertension in children. Surg News. Ministry of Health of the Byelorussia Republic 2017; 25:621-32. Available from: https://doi: 10.18484/2305-0047.2017.6.621

Gordon PV. Understanding intestinal vulnerability to perforation in the extremely low birth weight infant. Pediatr Res. 2009; 65:138-44. Available from:



How to Cite

Klyuev SA, Gorodkov SY, Goremykin IV, Masevkin VG. Neonatal gastric perforation in Twins: Two distinct cases. J Neonatal Surg [Internet]. 2023Nov.30 [cited 2024Feb.22];12:30. Available from: