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  • 2 -4 (66) 2024 - A.J.Khamraev, B.Z. Abdusamadov - DIAGNOSIS AND SURGICAL TREATMENT OF SPONTANEOUS PERFORATIONS OF THE GASTROINTESTINAL TRACT IN NEWBORNS

2 -4 (66) 2024 - A.J.Khamraev, B.Z. Abdusamadov - DIAGNOSIS AND SURGICAL TREATMENT OF SPONTANEOUS PERFORATIONS OF THE GASTROINTESTINAL TRACT IN NEWBORNS

DIAGNOSIS AND SURGICAL TREATMENT OF SPONTANEOUS PERFORATIONS OF THE GASTROINTESTINAL TRACT IN NEWBORNS

A.J.Khamraev Tashkent Pediatric Medical Institute

B.Z. Abdusamadov Tashkent Pediatric Medical Institute

I.M.Karimov Tashkent Medical Academy (TMA) Uzbekistan

G.G.Latipova Center for the Development of Professional Qualifications of Medical Workers under the Ministry of Health of the Republic of Uzbekistan

Resume

To analyze first-hand experience in treating newborns with spontaneous gastrointestinal perforations and develop an optimal algorithm for diagnosis and disease management to improve treatment outcomes for this group of patients.The work is based on the results of examination and treatment of 50 newborns with perforated peritonitis, among which 38 patients had necrotizing enterocolitis, and 13 had spontaneous gastrointestinal perforations. Based on a clinical study of newborns, clinical features of spontaneous gastrointestinal perforations compared with intestinal perforations in necrotizing enterocolitis have been identified. The most significant risk factors for spontaneous perforations of the gastrointestinal tract in newborns were acute birth asphyxia and pathology of the respiratory system, which required tracheal intubation in 100% of children. Respiratory distress syndrome was a leading risk factor in spontaneous perforations. Surgical tactics was determined by the type of perforation, the level of localization of the perforated hole, the prevalence of the pathological process in the wall of the hollow organ, and the overall health status of the child. In spontaneous perforations, the operation of choice was closure of perforation in 11 children. In 2 patients with spontaneous perforations, direct interintestinal anastomoses were performed with large defects in the intestinal wall, a limited pathological process, and the absence of widespread peritonitis. Case mortality rate was 50% among newborns with perforated necrotizing enterocolitis and 26% among patients with spontaneous perforations. Among children who died, the vast majority were premature newborns with low and very low body weight and serious comorbidities.

Keywords: newborn NEC, isolated gastrointestinal perforation.

First page

6

Last page

11

For citation: A.J.Khamraev, B.Z. Abdusamadov, I.M.Karimov, G.G.Latipova - DIAGNOSIS AND SURGICAL TREATMENT OF SPONTANEOUS PERFORATIONS OF THE GASTROINTESTINAL TRACT IN NEWBORNS //New Day in Medicine 4(66)2024 6-11 https://newdayworldmedicine.com/en/article/3758

List of References

  1. Attridge J.T., Clark R., Gordon P.V. New insights into spontaneous intestinal perforation using a national data set (3): antenatal steroids have no adverse association with spontaneous intestinal perforation. // J. Perinatol. 2008; 26: 667–70.
  2. Adant I., Miserez M., Naulaers G., Carkeek K., Ortibus E., Aerts R., Rayyan M. Long-term ontcomes of very low birth weight infants with spontaneous intestinal perforation: a retrospective case-matched cohort study. // J. Pediatr. Surg. 2019; 54 (10): 2084 – 2091.
  3. Boston V.E. Necrotizing enterocolitis and localized intestinal perforation: different disease or end of a spectrum of pathology. // Ped. Surg. Int. 2006; 22(6): 477 – 484.
  4. 28. Ragouilliaux C.J., Keeney S.E., Hawkins H.K., Rowen J.L. Maternal factors in extremely low birth weight infants who develop spontaneous intestinal perforation. // Pediatrics. 2007; 120: 1458–64.
  5. Elgendy M.M., Othman H.F., Heis F., Qattea I., Aly H. Spontaneous intestinal perforation in premature infants: a national study. // J. Perinatol. 2021; 41 (5): 1122- 1128.
  6. Fischer A., Vachon L., Durand M., Cayabyab R.G. Ultrasound to diagnose spontaneous intestinal perforations in infants weighting ≤ 1000g at birth. // J. Perinatol. 2015; 35 (2): 104 – 109..
  7. Gordon P.V. Understanding intestinal vulnerability to perforation in the extremely low birth weight infant. // Pediatr.Res. 2009; 65: 138– 44. 4
  8. Gordon P.V., Attridge J.T. Understanding clinical literature relevant to spontaneous intestinal perforations. // Am.J.Perinatol.2009; 26 (4): 309 – 316.
  9. Houben C.H., Feng X.N., Chan KWE, Mou JWC, Tam Y.H., Lee K.H. Spontaneous intestinal perforation: the long-term outcome. // J. Ped. Surg. 2017; 27 (4): 346 – 351.
  10. Hwang H., Murphy J.J., Cow K.W., Magee J.F. Are localized intestinal perforations distinct from necrotizing enterocolitis? J. Ped. Surg. 2003; 38 (5): 763 – 767.
  11. Kawase J., Ishii T., Arai H., Uga N. Gastrointestinal perforation in very low-birth weight infants. Pediatr. Int. 2006; 48 (6): 599 – 603.
  12. Lai S., Yu W., Wallace l., Sigalet D. Intestinal muscularispropria increases in thickness with corrected gestational age and is focally attenuated in patients with isolated intestinal perforations. J. Pediatr. Surg. 49; 2014: 114–9.
  13. Nakajima Y., Masaoka N., Yamamoto T. Obstetrical risk factors for local intestinal in very low birth weight infants. J. Perinatol. Med. 2011; 39 (2): 179 – 184.
  14. Olaloye O., Swatski M., Konnikova L. Role of nutrition in prevention of neonatal spontaneous intestinal perforation and its complications: a systematic review. Nutrients. 2020; 12 (5).
  15. Singh M., Owen A., Gull S., Morabito A., Bianchi A. Surgery for intestinal perforation in preterm neonates: anastomosis vs stoma. 2006. J.Ped.Surg; 41: 725 – 729.
  16. Raval M., Hall N., Pierro A., Moss R.L. Evidence-based prevention and surgical treatment of necrotizing enterocolitis – A review of randomized controlled trials. SeminarsinPediatricSurgery. 2013; 22: 117–21.

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