Abo-Halawa Nezar Abd Elrouf, Negm Mohamed Ahmed, Fathy Mohamed
Pediatric Surgery unit, Qena Faculty of Medicine, South Valley University, Qena, Egypt.
Pediatric Surgery Unit, Faculty of Medicine, Minia University, Minia, Egypt.
Ann Pediatr Surg. 2020;16(1):17. doi: 10.1186/s43159-020-00029-9. Epub 2020 Jun 25.
Neonatal gastro-intestinal perforation [NGIP] is one of the major problems in pediatric surgical practice. Although the outcomes of neonatal surgery have improved markedly over the past decade the mortality rates of neonates with NGIP are still high. The aim of this study was to present the possible etiological factors, clinical findings, and operative procedures of NIP in our locality.
A total of 34 neonates with NGIP were included in this study. The median age at presentation was (15.8 ± 7.0 SD) days. The median interval between presentation and surgical interference was (2.0 ± 1.1 SD).Necrotizing enterocolitis [NEC] was the commonest cause of neonatal gastro-intestinal perforation. The commonest site of perforation was the colon [11cases]. The overall mortality rate was 11 cases [32.4%]. The main cause of mortality was neonatal NEC [6 cases]. Eight cases [40 %] died out of 20 cases which the interval between the presentation and interference were more than one day.
Neonatal gastro-intestinal perforations are still associated with high mortality rate in our institutions, and delayed diagnosis with increased interval between the presentation and surgical intervention are associated with increased mortality. In our locality, although NEC is the commonest cause of NGIP, the iatrogenic cause is relatively higher than reported.
新生儿胃肠道穿孔（NGIP）是小儿外科实践中的主要问题之一。尽管在过去十年中新生儿手术的结果有了显著改善，但NGIP新生儿的死亡率仍然很高。本研究的目的是介绍我们当地NGIP可能的病因、临床表现和手术方法。
本研究共纳入34例NGIP新生儿。就诊时的中位年龄为（15.8±7.0标准差）天。就诊与手术干预之间的中位间隔为（2.0±1.1标准差）。坏死性小肠结肠炎（NEC）是新生儿胃肠道穿孔最常见的原因。最常见的穿孔部位是结肠（11例）。总死亡率为11例（32.4%）。死亡的主要原因是新生儿NEC（6例）。在就诊与干预间隔超过一天的20例病例中，有8例（40%）死亡。
在我们的机构中，新生儿胃肠道穿孔仍然与高死亡率相关，就诊与手术干预之间间隔时间延长导致的诊断延迟与死亡率增加相关。在我们当地，尽管NEC是NGIP最常见的原因，但医源性原因相对高于报道。
