Practical experience in the surgical treatment of newborns with isolated gastrointestinal perforations based on scientific evidence.

Q4 Medicine
Olga M Gorbatyuk, Taras V Martyniuk, Andrey A Momotov
{"title":"Practical experience in the surgical treatment of newborns with isolated gastrointestinal perforations based on scientific evidence.","authors":"Olga M Gorbatyuk, Taras V Martyniuk, Andrey A Momotov","doi":"10.36740/WLek/203901","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Aim: To share first-hand experience in the surgical treatment of newborns with isolated gastrointestinal perforations.</p><p><strong>Patients and methods: </strong>Materials and Methods: This study examines 71 newborns with perforated peritonitis: 53 (74.65%) had necrotizing enterocolitis, 14 (19.72%) had isolated gastrointestinal perforations, and 4 (5.63%) had other intestinal perforations. Diagnosis involved clinical, laboratory, radiographic, ultrasound, and histological examinations of surgical and autopsy samples.</p><p><strong>Results: </strong>Results: The most significant risk factors for isolated perforations of the gastrointestinal tract in newborns were acute birth asphyxia and pathology of the respiratory system, which required tracheal intubation in 100% of children. Isolated perforations were localized in the stomach (n=6), jejunum (n=3), ileum (n=2), duodenum (n=1), colon (n=2). Morphological features of isolated perforations are as follows: a rapid muscle layer wasting of the wall, sometimes with the absence of muscle fragments; vascular malformations in the submucosal layer of the wall; ulcerous defect without necrotic changes; absence of pneumatosis of the intestinal wall. In isolated perforations, the operation of choice was closure of perforation in 11 children. In 2 patients direct interintestinal anastomoses were performed. Case mortality rate was 21.43% (3 newborns died).</p><p><strong>Conclusion: </strong>Conclusions: 1. Clinical and pathomorphological features of gastrointestinal perforations in newborns indicate that isolated perforations are a separate nosological entity. 2. Isolated perforations of the gastrointestinal tract in newborns are characterized by such clinical differences as distress syndrome, prematurity, early onset, local lesions of a hollow organ, moderate peritonitis, favorable course and prognosis. 3. Isolated perforations are secondary to fibromuscular dysplasia of the wall of a hollow organ, indicating congenital pathology. 4. The operation of choice for isolated perforations is the excision of the edges of the perforation and closure of the perforation. 5. The prognosis for the gastrointestinal isolated perforations is favorable. Mortality was 21,43%.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"78 4","pages":"894-899"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Wiadomosci lekarskie","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36740/WLek/203901","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: Aim: To share first-hand experience in the surgical treatment of newborns with isolated gastrointestinal perforations.

Patients and methods: Materials and Methods: This study examines 71 newborns with perforated peritonitis: 53 (74.65%) had necrotizing enterocolitis, 14 (19.72%) had isolated gastrointestinal perforations, and 4 (5.63%) had other intestinal perforations. Diagnosis involved clinical, laboratory, radiographic, ultrasound, and histological examinations of surgical and autopsy samples.

Results: Results: The most significant risk factors for isolated perforations of the gastrointestinal tract in newborns were acute birth asphyxia and pathology of the respiratory system, which required tracheal intubation in 100% of children. Isolated perforations were localized in the stomach (n=6), jejunum (n=3), ileum (n=2), duodenum (n=1), colon (n=2). Morphological features of isolated perforations are as follows: a rapid muscle layer wasting of the wall, sometimes with the absence of muscle fragments; vascular malformations in the submucosal layer of the wall; ulcerous defect without necrotic changes; absence of pneumatosis of the intestinal wall. In isolated perforations, the operation of choice was closure of perforation in 11 children. In 2 patients direct interintestinal anastomoses were performed. Case mortality rate was 21.43% (3 newborns died).

Conclusion: Conclusions: 1. Clinical and pathomorphological features of gastrointestinal perforations in newborns indicate that isolated perforations are a separate nosological entity. 2. Isolated perforations of the gastrointestinal tract in newborns are characterized by such clinical differences as distress syndrome, prematurity, early onset, local lesions of a hollow organ, moderate peritonitis, favorable course and prognosis. 3. Isolated perforations are secondary to fibromuscular dysplasia of the wall of a hollow organ, indicating congenital pathology. 4. The operation of choice for isolated perforations is the excision of the edges of the perforation and closure of the perforation. 5. The prognosis for the gastrointestinal isolated perforations is favorable. Mortality was 21,43%.

基于科学证据的新生儿孤立性胃肠道穿孔手术治疗的实践经验。
目的:分享新生儿孤立性消化道穿孔的手术治疗经验。患者与方法:材料与方法:本研究对71例新生儿穿孔性腹膜炎进行了分析,其中坏死性小肠结肠炎53例(74.65%),孤立性胃肠道穿孔14例(19.72%),其他肠道穿孔4例(5.63%)。诊断包括临床、实验室、放射学、超声和手术和尸检样本的组织学检查。结果:新生儿孤立性胃肠道穿孔最重要的危险因素是急性出生窒息和呼吸系统病变,100%的患儿需要气管插管。孤立穿孔位于胃(n=6)、空肠(n=3)、回肠(n=2)、十二指肠(n=1)、结肠(n=2)。孤立穿孔的形态学特征如下:壁肌层迅速损耗,有时无肌块;管壁粘膜下层血管畸形;溃疡性缺损,无坏死改变;肠壁无肺积症。在孤立性穿孔中,11例患儿选择闭合穿孔。2例患者行直接肠间吻合。病例死亡率为21.43%(新生儿死亡3例)。结论:1.结论:新生儿胃肠道穿孔的临床和病理形态学特征表明,孤立的穿孔是一个单独的疾病实体。2. 新生儿孤立性胃肠道穿孔的临床差异表现为窘迫综合征、早产、早发、局部空洞脏器病变、中度腹膜炎、病程和预后良好。3. 孤立穿孔继发于中空器官壁的纤维肌肉发育不良,提示先天性病理。4. 孤立射孔的手术选择是切除射孔边缘并关闭射孔。5. 胃肠道孤立穿孔的预后良好。死亡率为21.43%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Wiadomosci lekarskie
Wiadomosci lekarskie Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
482
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信