Clinical course and management of pediatric gastroduodenal perforation beyond neonatal period

Abstract

Background

The treatments and outcomes of pediatric gastroduodenal perforations have rarely been described.

Methods

We retrospectively identified 515 patients aged 28 days to 17 years who were hospitalized for gastroduodenal perforation between July 2010 and March 2021 using a nationwide inpatient database. We compared characteristics, treatments, and outcomes for pediatric gastroduodenal perforation between children aged <7 years (n = 38) and ≥7 years (n = 477).

Results

Children aged <7 years had a higher prevalence of females, comorbidities, and gastric perforation than those aged ≥7 years. Compared to children aged ≥7 years, children aged <7 years were more likely to receive surgical treatment (79% vs. 55%), open surgery (58% vs. 19%), and supportive treatment such as mechanical ventilation (39% vs. 2.5%), treatment for disseminated intravascular coagulation (13% vs. 1.3%), catecholamines (32% vs. 2.7%), blood transfusion (37% vs. 2.1%), and intensive care unit admission (47% vs. 7.1%). Children aged <7 years had higher in-hospital mortality (5.3% vs. 0.4%) and morbidity (18% vs. 4.8%) than those aged ≥7 years.

Conclusions

In pediatric gastroduodenal perforation, children aged <7 years were more likely to have comorbidities, undergo surgical and supportive treatments, and demonstrate poor outcomes than those aged ≥7 years.