Massoumi Roxanne L, Abdelhafeez Abdelhafeez H, Christensen Melissa A, Vo Nghia J, Goday Praveen S, Leack Kathleen M, Duesing Lori A, Wagner Amy J
Medical College of Wisconsin, Milwaukee, Wisconsin.
Department of Surgery, Our Lady's Children's Hospital, Medical College of Wisconsin, Milwaukee, Wisconsin.
JPEN J Parenter Enteral Nutr. 2016 Nov;40(8):1177-1182. doi: 10.1177/0148607115575741. Epub 2015 Mar 9.
This is a case series in which 3 infants with gastrojejunostomy tube (GJT) insertion developed delayed perforation secondary to pressure necrosis. A review of all patients who underwent a GJT placement in 2013 was performed. Three of these patients developed surgically confirmed perforation secondary to pressure necrosis during this time period; no patients developed perforation at the time of GJT insertion. The indications for GJT insertion for all 3 patients were severe gastroesophageal reflux disease; 2 patients also had recurrent aspiration. The patients were between 9 weeks and 10 months of age at the time of GJT insertion. The site of perforation for all 3 cases occurred just distal to the ligament of Treitz between 48 and 72 hours following insertion. Given our 3 cases of perforation in patients weighing <10 kg, there may be a higher risk of perforation in low-weight patients.
这是一个病例系列，3例插入胃空肠造口管（GJT）的婴儿发生了因压迫性坏死继发的延迟性穿孔。对2013年所有接受GJT置入术的患者进行了回顾。在此期间，其中3例患者经手术证实因压迫性坏死发生穿孔；无患者在GJT插入时发生穿孔。所有3例患者GJT插入的指征均为严重胃食管反流病；2例患者还反复发生误吸。GJT插入时患者年龄在9周至10个月之间。所有3例穿孔部位均在插入后48至72小时发生于屈氏韧带远端。鉴于我们有3例体重<10 kg的患者发生穿孔，低体重患者可能有更高的穿孔风险。
