Spontaneous neonatal gastrointestinal perforation: surgical or conservative management?

Abstract

Background: Spontaneous neonatal gastrointestinal perforation occurs without any primary lesion of the gastrointestinal tract. It is a rare surgical emergency that may be caused by shunting of blood from renal, peripheral and mesenteric vascular bed to vital organs such as heart and brain during periods of perinatal stress.
Aim: To report three neonates with spontaneous gastrointestinal perforation.
Results: Between 2001 and 2005, we managed three cases of spontaneous gastrointestinal perforation in neonates at the University of Benin Teaching Hospital, Benin City. The perinatal stress factors were caesarian delivery, prematurity and fetal distress due to prolonged obstructed labour. Two had exploratory laparotomy and their perforations were closed in 2 layers while one was managed conservatively. They survived and were discharged after ten, thirty-six and eight days on admission and remained well during one year of follow up.
Conclusion: Early diagnosis, adequate resuscitation and timed surgical intervention resulted to encouraging outcome.


Keywords: Spontaneous, Neonatal gastrointestinal, Perforation

Port Harcourt Medical Journal Vol. 2 (1) 2007: pp. 90-94