Study of Gastrointestinal Perforation in Extremely Low Birth Weight Infants in Our Department

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  • Nui Akihiro
    Department of Pediatric Surgery, Hokkaido Medical Center for Child Health and Rehabilitation
  • Nishihori Shigeki
    Department of Pediatric Surgery, Hokkaido Medical Center for Child Health and Rehabilitation
  • Hashimoto Satsuki
    Department of Pediatric Surgery, Hokkaido Medical Center for Child Health and Rehabilitation
  • Yokoyama Shinichirou
    Department of Pediatric Surgery, Hokkaido Medical Center for Child Health and Rehabilitation
  • Hamada Hiromi
    Department of Pediatric Surgery, Hokkaido Medical Center for Child Health and Rehabilitation

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  • 当科における超低出生体重児消化管穿孔例の検討
  • トウ カ ニ オケル チョウテイシュッショウ タイジュウジ ショウカカン センコウレイ ノ ケントウ

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Abstract

<p>Purpose: In the case of gastrointestinal perforation in ELBWIs in our department, we examined the evaluation of the entire preoperative physical condition and treatment policy with regard to the life prognosis and psychiatric and neurological prognoses of surviving infants.</p><p>Methods: In the cases of gastrointestinal perforation in ELBWIs treated in our department, gestational age, birth weight, age at surgery, surgical weight, presence or absence of preoperative renal artery diastolic blood disruption, presence or absence of preoperative DIC, and so forth were compared between surviving and dead infants. In addition, postoperative enteral nutrition and postoperative PN in the presence or absence of psychiatric and neurological abnormalities in surviving infants were examined.</p><p>Results: Age at surgery, gestational age, birth weight, and surgical weight tended to be low in infants who died, in whom marked renal artery diastolic blood flow disruption and DIC were observed before surgery. Regarding psychiatric and neurological abnormalities, postoperative enteral nutrition started significantly earlier in normal-weight infants. In addition, although no significant difference was observed between the ELBWIs and normal-weight infants, the end time of postoperative PN was terminated early in normal cases.</p><p>Conclusions: Although the number of cases is small and further studies are needed in the future, the findings of this study suggest that the presence or absence of renal artery diastolic blood flow disruption and DIC may be effective indicators in preoperative systemic condition assessment. As for the surgical formula, the superiority of enterostomy was suggested because enteral nutrition can be established at an early stage.</p>

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