Document Detail

Gastrointestinal perforation in very low-birthweight infants.
MedLine Citation:
PMID:  17168981     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Spontaneous isolated gastrointestinal perforation (SIP) in very low-birthweight infants has been reported as a different disease entity from necrotizing enterocolitis (NEC). The objective of this study was to investigate the incidence and risk factors of NEC and SIP. METHODS: The authors reviewed the medical records of very low-birthweight infants who were admitted to Toho University Perinatal Center, Tokyo, Japan, between 1 January 1991 and 31 December 2002. The diagnosis of NEC was made with the finding of bloody gastric fluid or stool, abdominal distention, and abnormal abdominal X-ray findings such as pneumatosis intestinalis or fixed dilated intestinal loops. SIP was defined at laparotomy as the presence of an isolated gastrointestinal perforation surrounded by normal appearing bowel. RESULTS: A total of 556 very low-birthweight infants were included in this study. Of those, 15 infants were excluded because of major anomalies. Out of 541 infants, 14 were diagnosed to have NEC or gastrointestinal perforation. In total, 13 infants had gastrointestinal perforation and 10 were confirmed as SIP. Two SIP suggestive cases were included in SIP cases. There was only one case of NEC (0.2%) during 12 years in the authors' institute. Eight SIP cases had antenatal nonsteroidal anti-inflammatory drugs (NSAID). The treatment with antenatal NSAID was significantly associated with the incidence of SIP (p<0.001). CONCLUSION: The authors experienced only one proven case of NEC (0.2%), 12 cases of SIP (2.2%) among 556 very low-birthweight infants admitted during 12 years. Antenatal NSAID were strongly associated with SIP.
Yasuhiro Kawase; Tetsuya Ishii; Hiroko Arai; Naoki Uga
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics international : official journal of the Japan Pediatric Society     Volume:  48     ISSN:  1328-8067     ISO Abbreviation:  Pediatr Int     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-15     Completed Date:  2007-01-24     Revised Date:  2008-05-21    
Medline Journal Info:
Nlm Unique ID:  100886002     Medline TA:  Pediatr Int     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  599-603     Citation Subset:  IM    
Department of Neonatology, Toho University School of Medicine, Tokyo, Japan.
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MeSH Terms
Anti-Inflammatory Agents, Non-Steroidal / adverse effects
Diagnosis, Differential
Enterocolitis, Necrotizing / diagnosis,  etiology
Indomethacin / adverse effects
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / diagnosis*,  epidemiology,  etiology,  surgery
Infant, Very Low Birth Weight*
Intestinal Perforation / diagnosis*,  epidemiology,  etiology,  surgery
Japan / epidemiology
Medical Records
Retrospective Studies
Risk Factors
Stomach Rupture / diagnosis*,  epidemiology,  etiology,  surgery
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 53-86-1/Indomethacin

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