Conservative treatment of iatrogenic perforations caused by gastric tubes in extremely low birth weight infants

Abstract Background Iatrogenic gastrointestinal perforations are rare, but life-threatening events in preterm infants. Aim Aim of the study was to report on incidence, management, morbidity, and mortality. Study design This was a retrospective analysis performed at a tertiary neonatal intensive care unit in Vienna, Austria. Subjects Extremely low birth weight infants (ELBW, birth weight  Results During a 6-year study period 646 ELBW infants were analyzed. Incidence of perforations was 1.1% (n = 7/646). Median gestational age was 23 + 3 (range: 23 + 0–24 + 5). Perforations occurred on the third day of life (=median, range: day 2–14) and were primarily managed conservatively. Enteral feeding was stopped for 6 days (range: 4–13 days), antibiotic therapy administered for 16 days (range: 8–22 days). In one infant, gastrorrhaphy was performed. Conclusions Conservative treatment of upper GIT perforations led to spontaneous recovery without major complications in 85.7%.