Gastric Perforation

Neonatal gastric perforation is rare and life-threatening condition period and can be associated with overdistension, gastric intubation, ischemia, or idiopathic causes. Infants with this complication have a high mortality (25–50%). Typically there is a constellation of symptoms which can help identify this condition. These symptoms include fever, sepsis, abdominal distension, hematemesis, pneumoperitoneum, and respiratory failure. Recognition of the symptoms allows preoperative preparation including endotracheal intubation for respiratory failure, volume resuscitation, administration of antibiotics, and possible abdominal decompression. Traditional operative approaches and laparoscopy have been employed to correct this abnormality. Operative principles include control of spillage, debridement of devitalized tissue, and multiple repair techniques. Future investigation includes improvements in the understanding of the underlying causes of idiopathic and spontaneous perforation, improvement in prevention of the perforations of known cause, and advancement of repair techniques and approaches.