Abstract
Gastric ruptures in neonates are still one of the most unfavorable diseases. For the explanation of the genesis and unfavorable prognosis, gastric ruptures were produced experimentally in puppies by increasing intragastric pressure. Experimental gastric ruptures occurred along the lesser curvature different from clinical cases. Prior to the gastric mucosal rupture, tears of gastric muscle layer and serosa were observed in clinical impending rupture. Histology showed defects of muscle layer at ruptured edge, seemingly a result of contraction of the ruptured muscle. However, wide defects of muscle layer seen in the clinical cases could not be explained by contraction of ruptured muscle. Factors other than the increase of intragastric pressure, therefore, seemed to be important. Regarding a preoperative management (of gastric rupture), our experiment indicated that infusion therapy should be done within 4 hours after admission and surgery be started as soon as diuresis is obtained. Since severe peritonitis may be induced by formula milk intake, prohibition of milk intake along with the gastric decompression is considered to be an important procedure for suspected cases.
