X-RAY FINDINGS IN PEDIATRIC SURGICAL EMERGENCIES

(1) GASTRIC RUPTURE IN THE NEWBORN

Abstract

X-ray films of gastric rupture in the newborn infant were presented with a brief comment.
Case 1 : 1-day-old girl (birth weight 2, 800g.). She developed marked abdominal distention and cyanosis immediately after birth. An up-right scout film of the abdomen revealed massive pneumoperitoneum (Fig. 1) and the absence of the intestinal gas. The diagnosis of the gastric perforation with intestinal atresia was made. A linear tear, 2 cm, was found along the greater curvature high in the fundus. Atresia of the intestine was not confirmed at surgery. The gastric rent was closed in two layers and abdominal cavity was drained. The patient died shortly after operation. Permission for autopsy was refused.
Case 2 : 6-day-old boy (birth weight 3, 100 g.). There had been no difficulties with delivery and no gastric intubation or attempts at resuscitation. On the 6th day of life, he become dyspneic and developed abdominal distention. The plain up-right film of the abdomen revealed pneumoperitoneum. Laparotomy disclosed a 4 cm. linear tear along the greater curvature from the fundus to near the antrum. The rent was closed in two layers and abdominal cavity was drained. He expired on the 1st postoperative day. Postmortem examination revealed generalized peritonitis. The sutured areas in the stomach wall were intact.