Abstract:
Twenty neonates who were
diagnosed and managed as gastrointestinal
perforation during the period July 2009 to
June 2013 were prospectively analyzed for
age, sex, clinical features, management,
preoperative findings and postoperative
outcome. There were 14 boys and 6 girls.
The mean gestational age was 35 weeks
and mean birth weight was 2.10 Kg. Out of
20 neonates, the cause of perforation was
necrotizing enterocolitis(40%), spontaneous
bowel perforations (20%), Hirschsprung s
disease (10%), meconium ileus (10%),
volvulus (10%), anorectal malformation(5%)
and intestinal atresia (5%). Out of twenty
neonates eighteen underwent surgery. 6 out
of 20 died in this group. Multiple
perforations were seen in 3 neonates.
Primary closure of site was performed in 12
out of 20 patients of single perforation and
enterostomy in three. Twenty percentage of
patients developed post operative
complications. Post operative hospital stay
ranged from 8-30 days. Follow-up period
was ranging from 3 to 24 months Mortality
was 50% in necrotizing enterocolitis
patients. Overall mortality was 30%. Major
mortality risk factors include necrotizing
enterocolitis, multiple perforations, delayed
presentation, septicemia, low birth weight
and prematurity.