Gastrointestinal perforations in newborns with high mortality: A series of 18 cases

Authors

  • Monsoia G Yassegoungbe Department of Pediatric Surgery, National Teaching Hospital Hubert Koutoukou Maga, Cotonou, Benin
  • Beaudelaire R Assan Department of Pediatric Surgery, National Teaching Hospital Hubert Koutoukou Maga, Cotonou, Benin
  • Amoussou Sedjro Clotaire R Houegban Department of Pediatric Surgery, National Teaching Hospital Hubert Koutoukou Maga, Cotonou, Benin
  • Djifid M Seto Department of General Surgery, District Hospital of Allada, Allada, Benin
  • Codjo S Metchihoungbe Department of Pediatric Surgery, National Teaching Hospital Hubert Koutoukou Maga, Cotonou, Benin
  • Eudes Ulrich Elvis M Goudjo Department of Pediatric Surgery, National Teaching Hospital Hubert Koutoukou Maga, Cotonou, Benin
  • Houenoukpo Koco Department of Pediatric Surgery, National Teaching Hospital Hubert Koutoukou Maga, Cotonou, Benin
  • Sourou B Noukpozounkou Department of Pediatric Surgery, Mother and Child Teaching Hospital Lagune, Cotonou, Benin
  • Aldrico P Covi Department of Pediatric Surgery, National Teaching Hospital Hubert Koutoukou Maga, Cotonou, Benin
  • Michel A Fiogbe Department of Pediatric Surgery, National Teaching Hospital Hubert Koutoukou Maga, Cotonou, Benin

DOI:

https://doi.org/10.47338/jns.v9.548

Keywords:

Gastrointestinal perforation, NEC, Mortality, Prematurity, Neonate

Abstract

Gastrointestinal perforations (GIP) in newborns are serious neonatal conditions that have significant morbidity and mortality, especially in resource constrained setups. This study was done to describe our experience of GIP in neonates and identify the factors leading to high mortality in our setup. We collected 18 cases with GIP in neonates. The average age was 5.7 days (range, 1-7 days). The sex ratio was 0.64. The average time to treatment was 3.3 days (range, 1-10 days). The etiology of GIP was perforated necrotizing enterocolitis (13 patients), spontaneous gastric perforation (2 patients), perforated ileal atresia (1 patient), ileal perforation complicating a strangulated inguinoscrotal hernia (1 patient), and peritonitis after colostomy (1 patient). Mortality was 77.8% (n=14), among which 9 newborns (64.3%) died preoperatively. Prematurity, management delay, and lack of a neonatal intensive care unit were the main poor prognostic factors. Mortality from GIP is still high in our context due to several factors, especially prematurity, management delay, and lack of a neonatal intensive care unit.

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References

Kuremu RT, Hadley GP, Wiersma R. Gastrointestinal tract perforation in neonates. Tropical Doctor. 2007; 37:1-3.

Ekwunife OH, Ugwu J, Modekwe V, Osuigwe AN. Gastrointestinal perforation in neonates: Aetiology and risk factors. J Neonatal Surg. 2013; 2:30.

Rich BS, Dolgin SE. Necrotizing enterocolitis. Eur J Pediatr Surg Rep. 2013; 1:30–1.

Asabe K, Oka Y, Kai HI, Shirakusa T. Neonatal gastrointestinal perforation. Turk J Pediatr. 2009; 51:264-70.

Naji A, Elkarout Y, Benjiba N. Spontaneous neonatal gastric perforation: about a case. Pan Afr Med J. 2015; 21:1-6.

Dupont P, Trentesaux A, Guillemin M, Petit T, Jeanne-Pasquier C, Guillois B. Idiopathic gastric perforations of the newborn in two cases. Gastroenterol Clin Biol. 2003; 27: 1160-2.

Rakoto-Ratsimba HN, Rakotoarisoa B, Samison LH, Belalahy V, Ranaivozanany A. Spontaneous gastric perforation in a neonate: a case report. Archives de Pediatrie. 2004; 11:1067-9.

Eicher C, Seitz G, Bevot A, Moll M, Goelz R, Arand J. Surgical management of extremely low birth weight infants with neonatal bowel perforation: a single-center experience and a review of the literature. Neonatol. 2012; 101:285–92.

Jawed AJ, Al-Rabie A, Hadi A, Al-Sowailem A, Al-Rawaf A, Abu-Touk B. Spontaneous neonatal gastric perforation. Pediatr Surg Int. 2002; 18:396-9.

Cass D, Brandt M, Patel DL, Nuchtern JG, Minifee PK, Wesson D. Peritoneal drainage as definitive treatment for newborns with isolated bowel perforation. J Pediatr Surg. 2000; 35:1531-6.

Ein SH, Marshall DG, Grivan D. Peritoneal drainage under local anesthesia for necrotizing enterocolitis. J Pediatr Surg. 1977; 12: 963–7.

Khan RA, Mahajan JK, Rao KLN. Spontaneous intestinal perforation in neonates: Is surgery always indicated? Afr J Paediatr Surg. 2011; 8:249-51.

Lacusso C, Boscarelli A, Fusaro F, Bagolan P, Morini F. Pathogenetic and prognostic factors for neonatal gastric perforation: Personal experience and systematic review of the literature. Frontiers in Pediatrics. 2018; 6:1-6.

Rees CM, Eaton S, Kiely EM, Wade AM, McHugh K, Pierro A. Peritoneal drainage or laparotomy for neonatal bowel perforation? A randomized controlled trial. Ann Surg. 2008; 248: 44–51.

Osifo OD, Ovueni ME. The prevalence, patterns, and causes of deaths of surgical neonates at two African referral pediatric surgical centers. Ann Pediatr Surg. 2009; 5:194-9.

Singh M, Owen A, Gull, S, Morabito A, Bianchi A. Surgery for intestinal perforation in preterm neonates: anastomosis vs stoma. J Pediatr Surg. 2006; 41:725–9.

Govani DR, Patel RR, Patel RV, More B, Bhimni SD. Pneumo-omentocele - a sign of silent lethal neonatal posterior gastric perforation. Austin J Clin Case Rep. 2014; 1:1038.

Ehrlich PF, Sato TT, Short BL, Hartman GE. Outcome of perforated necrotizing enterocolitis in the very low-birth weight neonate may be independent of the type of surgical treatment. Am Surg. 2001; 67:752-6.

Tiwari C, Sandlas G, Jayaswal S, Shah H. Spontaneous intestinal perforation in neonates. J Neonatal Surg. 2015; 4:14.

Ameh EA. Challenges of neonatal surgery in Subsaharan Africa. Afr J Paediatr Surg. 2004; 1:43-8.

Published

2020-11-11

How to Cite

1.
Yassegoungbe MG, Assan BR, Houegban ASCR, Seto DM, Metchihoungbe CS, Goudjo EUEM, Koco H, Noukpozounkou SB, Covi AP, Fiogbe MA. Gastrointestinal perforations in newborns with high mortality: A series of 18 cases. J Neonatal Surg [Internet]. 2020Nov.11 [cited 2020Nov.27];9:32. Available from: https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/548

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Section

Short Communication