The neonatal gastric perforation is said that it rarely occurs only in neonate days. It requires the early dignosis and emergent operation, otherwise neonates suffer from hypovolemic shock and generalized peritonitis which result in a higher
mortality.
It is said that outbreak of the disease happens for premature babies and immature babies frequently, and the incidence of male babies is about four times as much as that of female babies. The illness occures within the first week of life and the
highest
incidence of rupture is on the third day of life. The causes of the disease are congenital gastric muscle defect, peptic ulcer, necrosis of the gastric tissue resulting from hypoxia, and mechanical including left diaphragmatic eventration and
congenital
intestinal obstruction, but we don's know the exact cause of the disease actually.
The clinical manifestations are various and chief findings are as follows; a baby who looks healthy but dosen't suck well, and suffers from vomiting, dyspnea, cyanosis and abdominal distention. The diagnosis can be done by abdominal X-ray finding
of
large free air under both diaphragm, and th only treatment it the exploration by early diagnosis.
We performed the exploration on 48 hours after symptoms happened for a three-day-old male baby who came to our hospital for vomiting and irritability and X-ray findings of chest and abdomen revealed left diaphragmatic eventration, serious
abdominal
distension and free air under the left diaphragm.
On the exploration of abdomen, gastric perforation, measuring 1.5~2.0 cm in length in the greater curvature of the body was found and appeared necrotic change around it. The edges were debrided and the defect was closed in two-layers. The
diaphragmatic
eventration was corrected by " horizontal mattress suture" with non-absorbable materials. He fed orally from third post operative day, suffered from wound infection and was discharged in twenty-first post operative day.
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