Gastric necrosis in newborns : a report of 11 cases

• Published in: Pediatric surgery international Vol. 13; no. 5-6; pp. 346 - 349
• Main Authors: PELIZZO, G, DUBOIS, R, LAPILLONNE, A, LAINE, X, CLARIS, O, BOUVIER, R, CHAPPUIS, J. P
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.07.1998; Berlin Springer Nature B.V
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Biopsy; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Endoscopy, Digestive System; Female; Follow-Up Studies; Gastrectomy; Gestational Age; Humans; Infant, Newborn; Intensive care medicine; Male; Medical sciences; Necrosis; Stomach - pathology; Stomach - physiopathology; Stomach - surgery; Stomach Diseases - diagnosis; Stomach Diseases - etiology; Stomach Diseases - physiopathology; Stomach Diseases - surgery; Treatment Outcome; Human; Vascular disease; Case study; Stomach; Newborn diseases; Newborn; Infarct; Cardiovascular disease; Digestive diseases; Gastric disease; Necrosis
• ISSN: 0179-0358; 1437-9813
• DOI: 10.1007/s003830050335

Eleven neonates ranging in gestational age from 34 to 40 weeks presented with gastric necrosis. The 4 full-term neonates showed sudden-onset hemorrage and "coffee-ground" vomiting; in the 7 premature babies the initial clinical finding was abdominal distention. The criteria for diagnosis were: perinatal distress in prematures and transient neonatal respiratory distress in full-term babies. Radiographic evidence of gastric distention was typical and preceded clinical signs of hematemesis and gastric perforation. Surgery was performed in 8 patients; 3 received medical treatment. At surgery 1 total and 3 subtotal gastrectomies and 4 segmental gastric resections were performed. Three of these patients died post-operatively as a consequence of multiorgan failure; a second look was necessary in one patient 1 week after surgery because of prepyloric perforation due to ulcers. Biopsy specimens taken from the site of perforation demonstrated extensive necrosis; ulceration was disseminated in the surrounding gastric mucosa; no signs of phlogosis were detected. The diagnosis, treatment, and physiopathologic considerations are reviewed.