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Neonatal Total Gastric Rupture with Bilateral Pneumoscotum in a Preterm Infant - Abstract

Hemant Kumar, Ramnik Patel, Bharat More, Bala Eradi, Haitham Dagash, Ashok Rajimwale

 

Abstract

A preterm infant and twin 1 of the dichorionic diamniotic twins born at 27+3/40 weeks gestation weighting 790 grams who had on-going respiratory distress developed total gastric rupture following difficult intubation. Plain chest, abdominal and right lateral decubitus radiographs helped in diagnosis. Infant had resuscitation and underwent exploratory laparotomy, closure of massive gastric rupture and temporary gastrostomy for decompression initially and feeding later uneventfully. Neonatal gastric perforation is rare, serious and potentially lethal if not detected early and treated effectively. It could be traumatic, spontaneous or ischaemic. Our case had acute barotrauma following accidental oesophageal intubation and closed loop obstruction due to cardiac and pyloric sphincter at both ends and relatively high velocity air entering under pressure leading to anterior gastric wall blast. Primary repair of the stomach rupture with temporary gastrostomy is very useful and effective therapeutic strategy in these very sick preterm infants.

Keywords: preterm, gastric perforation, pneumoperitoneum, acute pneumoscotum, peritonitis, neonatal, gastrostomy, traumatic, iatrogenic

 

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