All issues > Volume 35(4); 1992

Original Article

J Korean Pediatr Soc. 1992;35(4):476-483. Published online April 15, 1992.

Clinical Study of Gastrointestinal Perforation in the Newborn

K.N. KN Kim¹, Y.T. YT Jang¹, O.K. OK Lee¹, W.S. WS Kim¹

¹Department of Pediatrics, Presbyterian Medical Center, Chonju, Korea

Abstract

A clinical study was made on 17 neonates with gastrointestinal perforation admitted to the department of pediatrics Presbyterian Medical Center from January 1980 to January 1991. The following results were obtained. 1) Males were predominantly developed and the time of perforations occurs mainly in the 1 st week of life(70.6%). 2) The 17.5 percent of total cases were prematurity of low birth infant. 3) The symptoms and clinical signs in gastrointestinal perforated neonates were abdominal distension, frequent vomiting, difficult respiration, poor sucking, bloody stool and others, and the histologic findings were tissue necorsis, hemorrhage, ulcer and others. 4) In X-ray finding, pneumoperitoneum was not detected in the 18.8 percent of gastrointestinal perforated neonates. 5) The perforated sites of gastrointestinal tract in the confirmed cases by operation were lower gastrointestinal tract in 30.0 percent. 6) Possible etiologic factors of gastrointestinal perforation were intestinal obstructions, Barium enema, necrotizing enterocolitis and others, and could not been found in 4 cases regarded as spontaneous gastrointestinal perforation. 7) The gastrointestinal perforation caused by intestinal obstruction was developed in lower gastrointestinal tract, by necrotizing enterocolitis in ileum, and by spontaneous gastrointestinal perforation mainly in the greater curvature of stomach and sigmoid colon. 8) The perforation of gastrointestinal tract was developed after 1st week of life in necrotizing enterocolitis and was developed within 1st week of life in intestinal obstruction and in 75 percent of spontaneous gastrointestinal perforation. 9) Survival rate in operative cases was 54.5 percent and 41.2 percent in total cases. 10) Prognosis was better in full term infants, infants with upper gastrointestinal perforation and spontaneous gastrointestinal perforation than that in prematurity and low birth infants, infants with lower gastrointestinal perforation and necrotizing enterocolitis.

Keywords :Gastrointestinal perforation