Jeik Byun, Hyun Young Kim, Seung Yeon Noh, Soo Hong Kim, Sung Eun Jung, Seong Cheol Lee, Kwi Won Park, Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul 110-744, South Korea.
World J Gastrointest Surg. 2014 Aug 27;6(8):151-5. doi: 10.4240/wjgs.v6.i8.151.
To determine the etiology and prognostic factors for neonatal gastric perforation (NGP), a rare but life-threatening disease.
Between 1980 and 2011, nine patients underwent surgical intervention for NGP at Seoul National University Children's Hospital. The characteristics and prognosis of the patients were retrospectively analyzed.
Among the nine patients, three (33.3%) were preterm babies and five (55.5%) had associated anomalies, which included diaphragmatic eventration (n = 2), congenital diaphragmatic hernia, esophageal atresia with tracheoesophageal fistula, and antral web. Three (33.3%) patients were born before 1990 and three (33.3%) had a birth weight < 2500 g. Pneumoperitoneum was found on preoperative images in six (66.7%) patients, and incidentally in the other three (33.3%) patients. Surgery was performed within 24 h after the onset of symptoms in seven (77.8%) patients. The overall mortality rate was 22.2% (2/9). The time between symptoms and surgical intervention was the only prognostic factor for survival, whereas premature birth and birth weight were not.
Early detection and advances in neonatal intensive care may improve the prognosis of NGP.
明确新生儿胃穿孔（NGP）的病因和预后因素，该病虽然罕见但危及生命。
1980 年至 2011 年间，9 名 NGP 患者在首尔国立大学儿童医院接受了手术干预。回顾性分析了患者的特征和预后。
9 名患者中，3 名（33.3%）为早产儿，5 名（55.5%）存在相关畸形，包括膈膨升（n=2）、先天性膈疝、食管闭锁伴气管食管瘘和胃窦部隔膜。3 名（33.3%）患者出生于 1990 年以前，3 名（33.3%）出生体重<2500g。6 名（66.7%）患者术前影像学检查发现气腹，另外 3 名（33.3%）患者为偶然发现。7 名（77.8%）患者在症状出现后 24 h 内进行了手术。总体死亡率为 22.2%（2/9）。症状与手术干预之间的时间是唯一的生存预后因素，而早产和出生体重不是。
早期发现和新生儿重症监护的进步可能改善 NGP 的预后。
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