Characteristics and prognoses of neonatal gastric perforation

Objective To explore the characteristics of neonatal gastric perforation and analyze its prognostic factors. Methods From January 2005 to June 2017, 27 neonatal patients diagnosed as gastric perforation were recruited and their characteristics were analyzed. There were 21 boys (77.78%) and 6 girls (22.22%) with a mean age of 4.05 (3.24-7.01) days. The causes were congenital gastric muscular wall defects (n=12, 44.44%), gastric stress ulcer perforation (n=1, 3.71%) and non-specific (n=14, 51.85%). And the locations were at great curvature (n=16, 59.26%), lesser curvature (n=3, 11.11%), anterior wall (n=6, 22.22%) and posterior wall (n=2, 7.41%). Prognostically they were divided into fatality and survival groups. Relevant factors of two groups were analyzed and follow-ups conducted for survival group. Results Among them, 17 (62.96%) were in survival group and 10 (37.04%) in fatality group. Age, gender, prematurity, low birth weight, perinatal adverse events, alimentary malformation, time from onset to surgery, length of perforation and congenital gastric muscular wall defects had no statistically significant inter-group differences (P>0.05). And gastrointestinal ischemia & necrosis and multiple organ dysfunction syndrome (MODS) were statistically significant (P<0.001). During a follow-up period of 39.40±26.33 months, 17 survivors had favorable growth and development. Only 2 cases (11.76%) of intestinal obstruction required a second surgery. Conclusions Neonatal gastric perforation has a fatality rate of 37.04%. Severity of disease determines its prognosis instead of perinatal condition or alimentary malformation. Early diagnosis and timely surgery favorably affects its prognosis. Key words: Gastric perforation; Prognosis; Fatality rate