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.