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01.12.2023 | Original Article

Association between gastrointestinal perforation and patent ductus arteriosus in extremely-low-birth-weight infants: a retrospective study of our decade-long experience

verfasst von: Mitsuru Muto, Koshiro Sugita, Masakazu Murakami, Shinichiro Ikoma, Masato Kawano, Ryuta Masuya, Makoto Matsukubo, Takafumi Kawano, Seiro Machigashira, Kazuhiko Nakame, Motofumi Torikai, Takamasa Ikee, Hiroyuki Noguchi, Satoshi Ibara, Satoshi Ieiri

Erschienen in: Pediatric Surgery International | Ausgabe 1/2023

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Abstract

Purpose

Management of persistently patent ductus arteriosus (PDA) in extremely low-birth-weight infants (ELBWIs) requires attention due to the risk of tissue hypoperfusion. We investigated the association between PDA and gastrointestinal perforation.

Methods

We performed a retrospective chart review from 2012 to 2021. Preterm (≤ 32 weeks) ELBWIs with PDA after birth who developed necrotizing enterocolitis (NEC), focal intestinal perforation (FIP), and idiopathic gastric perforation were included; ELBWIs with congenital heart disease were excluded. Data were analyzed using chi-squared tests with Yates; correction, and Student’s t test.

Results

Five hundred thirty-five preterm ELBWIs were analyzed, including 20 with NEC, 22 with FIP, and 1 with gastric perforation. In NEC and FIP, the ductus arteriosus remained open in 40% (4/10) and 63.6% (14/22) of cases, respectively, and cyclo-oxygenase inhibitor treatment showed poor efficacy (p = 0.492 and 0.240). The incidence of perforation in NEC (4/9 vs. 6/11, p = 0.653), mortality in NEC (3/4 vs. 3/6, p = 0.895) and FIP (6/14 vs. 3/8, p = 0.838) did not differ according to whether the PDA persisted or resolved.

Conclusion

The presentation of PDA did not affect the mortality or morbidity of ELBWIs. However, it is essential to consider the possibility of gastrointestinal perforation due to decreased organ blood flow caused by ductal steal.

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Titel: Association between gastrointestinal perforation and patent ductus arteriosus in extremely-low-birth-weight infants: a retrospective study of our decade-long experience
verfasst von: Mitsuru Muto
Koshiro Sugita
Masakazu Murakami
Shinichiro Ikoma
Masato Kawano
Ryuta Masuya
Makoto Matsukubo
Takafumi Kawano
Seiro Machigashira
Kazuhiko Nakame
Motofumi Torikai
Takamasa Ikee
Hiroyuki Noguchi
Satoshi Ibara
Satoshi Ieiri
Publikationsdatum: 01.12.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 1/2023
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-023-05420-2

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Association between gastrointestinal perforation and patent ductus arteriosus in extremely-low-birth-weight infants: a retrospective study of our decade-long experience