Neonatal Gastric Perforation – A Case Report Harsh

Abstract

Gastric perforation in neonates is a very rare surgical emergency and life-threatening condition with uncertain etiology till date. Despite having high mortality rate, pathogenesis and etiology are greatly debated. Because of its high mortality rate, prompt diagnosis and urgent surgical intervention is mandatory.  Herewith we report a case of neonatal gastric perforation having no apparent etiology. A 3 day old full term twin delivery male baby with neonatal gastric perforation presented with abdominal distention and respiratory distress. Baby was with low birth weight and was in septicemia during admission. He was diagnosed radiologically on X ray abdomen showing ‘saddle bag’ appearance and demonstrating gas out lining falciform ligament and managed by resuscitation and surgery. On exploration there was a 1 cm x 1 cm perforation seen on the fundic region along the greater curvature which was circular with pouting mucosa through it, surrounding serosa was hyperemic, no evidence of necrosis or petechial hemorrhage around perforation; primary repair was done. Postoperatively, despite of intensive care by means of invasive ventilation, intravenous fluids and broad spectrum antibiotics, condition of baby started deteriorating and he expired 40 hours after operation. Cause of death was septicemia secondary to peritonitis in low birth weight baby. Key words: Neonate, Gastric, Perforation, Peritonitis