Некроз и перфорации желудка у новорождённых и детей раннего возраста

Abstract

The Objective of the study was to identify the clinical features of newborns and infants with perforation of the stomach, and to justify the possibility of organ-preserving operations even with extensive gastric necrosis. Methods and Materials. The results of treatment of 32 newborns with stomach perforation was analyzed: not only the risk factors that cause this condition, but diagnostic methods and variants of surgical treatment. All patients with extensive necrosis of the stomach wall underwent an atypical resection within healthy tissues, a gastric «tube» was formed on the drainage probe with a significant decrease of organ volume. In cases of the local damage of the gastric wall, the perforated area was sutured after the excision of the edges of the defect. Results . Mortality rate was 36.5 % (n = 12). The cause of death in 5 children (15 %), in 3 to 8 days after surgery, was multiple organ failure syndrome. In 7 patients (22 %), a fatal outcome occurred due to the severe post-intensive care syndrome at the age of 3 to 12 months of life. Conclusion. The mechanism of perforations of the stomach in newborns and infants is multifactorial. All children with stomach perforation need preoperative preparation. The operation of choice for the stomach perforation is an organpreserving surgery. The function of the stomach is restored in all children after extensive resection of the stomach.