Gastric necrosis in newborns: a report of 11 cases.
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.
Pelizzo
G
G
Department of Pediatric Surgery, Hôpital E. Herriot, 69003 Lyon, France.
Dubois
R
R
Lapillonne
A
A
Lainé
X
X
Claris
O
O
Bouvier
R
R
Chappuis
J P
JP
D001706:Biopsy; D016145:Endoscopy, Digestive System; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009336:Necrosis; D013270:Stomach / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D013272:Stomach Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome