PERFORATION OF GASTROINTESTINAL-TRACT IN INFANCY AND CHILDHOOD

  • 1 January 1978
    • journal article
    • research article
    • Vol. 146  (6) , 926-928
Abstract
Patients (88) with perforations of the gastrointestinal tract in infancy and childhood, excluding those caused by appendicitis, are presented. Patients (55) were 4 wk old or younger. Of the perforations, 14 occurred during the 1st yr of life and 19 occurred between 1 and 15 yr of age. The locations of perforations by order of frequency were the ileum, rectosigmoid, stomach and duodenum. The causes in order of frequency were necrotizing enterocolitis, ulcers, unknown causes, Hirschsprung''s disease, atresia of the small intestine, volvulus, trauma, gastroschisis and ventriculoperitoneal shunts for hydrocephalus. A high index of suspicion, aided by roentgenograms, is essential for an early diagnosis. The overall mortality was 49 of 88 patients. No reduction in mortality was observed in the last 10 yr, despite improved surgical techniques and better antimicrobial agents. Early recognition and rapid transport of the child to a pediatric intensive care unit with better supportive measures plus antimicrobial agents effective against both anaerobic and aerobic bacteria should reduce this high mortality.

This publication has 0 references indexed in Scilit: