Gastrointestinal Perforation in Infants: Cases Unrelated to Necrotizing Enterocolitis

與壞死性腸炎無關之嬰幼兒腸胃道穿孔之病例

蕭佩宏(Pei-Hung Hsiao) ； 周怡宏(Yi-Hong Chou) ； 鄒國英(Kuo-Inn Tsou Yau) ； 張美惠(Mei-Hwei Chang)

《Acta Paediatrica Sinica》 34卷6期 (1993/12) Pp. 429-435

摘要

自民國七十三年元月至八十一年三月，台大醫院小兒科共經歷十九例與壞死性腸炎無關的腸胃道破裂。其中十二例(63%)乃足月兒。破裂發生處以小腸最多(47%)，胃部居次(32%)，大腸再次之(16%)。臨床症狀以腹脹最為常見(95%), 腸音減少或消失居次(74%)。腹腔積氣可在63%病例中發現。約60%病例發生破裂的時間在生後四日內。破裂的原因以自發性者居多(8/19, 42%)，其次為由缺血或梗塞而來(5/19，26%)。其死亡率為32%。死亡病例之酸中毒程度較存活例嚴重，且敗血症可見於83%的死亡例。吾人的建議為早期診斷及適當治療為提高存活率最好的作法。

並列摘要

From January 1984 to March 1992, there were 19 infants admitted to our hospital with gastrointestinal perforation not associated with necrotizing enterocolitis. Seven patients (37%) were premature. Six patients (32%) had their perforations located in the stomach, 9 (47%) in the small intestine. and 3(16%) in the colon. The most common clinical presentation was abdominal distention (95%). Pneumoperitoneum was noted only in 12(63%) patients. About 60% of the patients had the perforation occur before 4 days of age. The predominant cause of perforation was unknown, so called spontaneous perforation (8/19, 42%), followed by ischemia or infarction (5/19, 26%). The overall mortality rate was 32%. The non-survivors had more severe metabolic acidosis than the survivors, but there were no differences in the birthweight and gestational ages of these two groups. Sepsis accounted for 83% of the deaths. Early diagnosis and treatment are the best ways to promote survival.

並列關鍵字

gastrointestinal perforation