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Neonatal gastric perforations; A diagnostic clue in pre-perforative phase

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Abstract

This paper is a retrospective analysis of the pre-perforative clinical picture in twenty-seven neonates with gastric perforations. In fifteen there was a remarkably consistent progressive pattern in the preperforative clinical course. We separated the clinical course of the disease into three distinct stages in relation to pathological changes in the gastric wall i.e. gastric ischemia and dysfunction, transmural peritonitis and paralytic ileus, and actual perforation. Emphasis was placed on the existance of a clinically detectable pre-perforative phase which, if interpreted correctly, should lead to earlier diagnosis and consequently more satisfactory therapeutic results.

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References

  1. Marchildon, M. M.: Meconium peritonitis and spontaneous gastric perforations. Clinics in Perinatology 5: 79–91, 1978.

    PubMed  CAS  Google Scholar 

  2. Vargas, L. L. Levin, S. M. and Santulli, T. V.: Rupture of the stomach in the newborn infant. Surg. Gyn. Obst. 101: 417–424, 1955.

    PubMed  CAS  Google Scholar 

  3. Linkner, L. M. and Benson, C. D.: Spontaneous perforation of the stomach in the newborn: analysis of thirteen cases. Ann. Surg. 149: 525–535, 1959.

    PubMed  CAS  Google Scholar 

  4. Kiesewetter, W. B.: Spontaneous rupture of the stomach in the newborn. Amer. J. Dis. Child. 91: 162–167, 1956.

    CAS  Google Scholar 

  5. Scholander, P. F.: The master switch of life. Scien. Amer. 209: 92–106, 1963.

    Article  CAS  Google Scholar 

  6. Lloyd, J. R.: The etiology of gastrointestinal perforations in the newborn. J. Pediatr. Surg. 4: 77–84, 1969.

    Article  PubMed  CAS  Google Scholar 

  7. Lloyd, J. R.: Pediatric Surgery. 3rd ed. pp. 8–87 891, Year Book Med. Pub. Chicago, 1970.

    Google Scholar 

  8. Touloukian, R. J. Posch, J. N. and Spencer, R.: The pathogenesis of ischemic gastroenterocolitis of the neonate: selective gut mucosal ischemia in asphyxiated neonatal piglets. J. Pediatr. Surg. 7: 194–205, 1972.

    Article  PubMed  CAS  Google Scholar 

  9. Touloukian, R. J.: Gastric ischemia: the primary factor in neonatal perforation. Clin. Pediatr. 12: 219–225, 1973.

    CAS  Google Scholar 

  10. Johansen, K.: Regional distribution of circulating blood during submersion asphyxia in the duck. Acta. Physiol. Scand. 62: 1–9, 1964.

    Article  PubMed  CAS  Google Scholar 

  11. Elsner, R. Kenny, D. W. and Burgess, K.: Diving bradycardia in the trained dolphin. Nature 212: 407–408, 1966.

    Article  PubMed  CAS  Google Scholar 

  12. Harrison, W., M. Connell, R. S., Campbell, J. R. and Webb, M. C.: Fine structural changes in the gastro-intestinal tract of the hypoxic puppy: a study of natural history. J. Pediat. Surg. 12: 403–408, 1977.

    Article  PubMed  CAS  Google Scholar 

  13. Harrison, M. W., Connell, R. S., Cambell, J. R. and Webb, M. C.: Microcirculatory changes in the gastrointestinal tract of the hypoxic puppy: an electron microscope study. J. Pediat. Surg. 10: 599–608, 1975.

    Article  PubMed  CAS  Google Scholar 

  14. Arima, A. Kojima, Y. Shimamoto, K. Sakoguchi, Y. Tajima, N. Ikawa, M. Akita, H. and Kikuchi, J.: Neonatal gastric ruptures. Proceedings of the 16th Annual Meeting of the Japanese Society of Pediatric Surgeons pp. 215, 1979.

  15. Kosloske, A. M. and Lilly, J. R.: Paracentesis and lavage for diagnosis of intestinal gangrene in neonatal necrotizing enterocolitis. J. Pediat. Surg. 13: 315–320, 1978.

    PubMed  CAS  Google Scholar 

  16. Purkert, W. J. and Hoy, G. R.: Technique for continous sampling of peritoneal fluid for prediction of intestinal gangrene. J. Pediat. Surg. 16: 58–60, 1980.

    Google Scholar 

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Kadowaki, H., Takeuchi, S., Nakahira, M. et al. Neonatal gastric perforations; A diagnostic clue in pre-perforative phase. The Japanese Journal of Surgery 13, 446–451 (1983). https://doi.org/10.1007/BF02469734

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  • DOI: https://doi.org/10.1007/BF02469734

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