Korean J Perinatol.  2013 Jun;24(2):89-94. 10.14734/kjp.2013.24.2.89.

Comparison of Clinical Findings of Gastric Perforation between Preterm and Term Neonates

  • 1Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea. lsl@dsmc.or.kr
  • 2Department of Pediatric Surgery, Keimyung University School of Medicine, Daegu, Korea.


The purpose of this study was to compare the clinical findings and mortality of gastric perforation between preterm and term infants.
The medical records of neonates, admitted to the neonatal intensive care unit of Dongsan Medical Center for gastric perforation between July 1992 and June 2012, were reviewed retrospectively. The admission records of clinical findings and mortality were reviewed and statistically analyzed between preterm and term infants.
Nine infants were diagnosed with neonatal gastric perforation. Of the nine infants, the number of term infants was five and the number of male was eight. Of the four infants diagnosed with spontaneous gastric perforation, the number of preterm and term infants was three and one respectively. The anatomical location of perforation was greater curvature in all four preterm infants. However, various sites such as greater curvature (three infants) and antrum (two infants) were observed in five term infants. Mortality rate was tended to be lower in preterm infants compared to term infants, without statistical significance (25.0% vs. 40.0%, P>0.1). There was no mortality in four infants diagnosed with spontaneous gastric perforation. However, two infants diagnosed with necrotizing enterocolitis (NEC) all died.
There was no significant difference in clinical findings and mortality of gastric perforation between preterm and term infants. The prognosis of spontaneous gastric perforation was good, however, mortality rate was tended to be higher in NEC than other causes (P=0.083).


Gastric Perforation; Neonate; Preterm infant; Term infant

MeSH Terms

Enterocolitis, Necrotizing
Infant, Newborn
Infant, Premature
Intensive Care, Neonatal
Medical Records
Retrospective Studies


1). Terui K., Iwai J., Yamada S., Takenouchi A., Nakata M., Komatsu S, et al. Etiology of neonatal gastric perforation: a review of 20 years' experience. Pediatr Surg Int. 2012. 28:9–14.
2). Tan CE., Kiely EM., Agrawal M., Brereton RJ., Spitz L. Neonatal gastrointestinal perforation. J Pediatr Surg. 1989. 24:888–92.
3). Grosfeld JL., Molinari F., Chaet M., Engum SA., West KW., Rescorla FJ, et al. Gastrointestinal perforation and peritonitis in infants and children: experience with 179 cases over ten years. Surgery. 1996. 120:650–5. discussion 5-6.
4). Rhim SY., Jung PM. Clinical study of neonatal gastric perforation. J Korean Assoc Pediatr Surg. 2005. 11:123–30.
5). Hwang S., Park J., Chang S. Clinical review of spontaneous gastric perforation in the newborn. J Korean Assoc Pediatr Surg. 2003. 9:30–4.
6). Lin CM., Lee HC., Kao HA., Hung HY., Hsu CH., Yeung CY, et al. Neonatal gastric perforation: report of 15 cases and review of the literature. Pediatr Neonatol. 2008. 49:65–70.
7). Kara CS., Ilce Z., Celayir S., Sarimurat N., Erdogan E., Yeker D. Neonatal gastric perforation: review of 23 years' experience. Surg Today. 2004. 34:243–5.
8). Holgersen LO. The etiology of spontaneous gastric perforation of the newborn: a reevaluation. J Pediatr Surg. 1981. 16:608–13.
9). Woo J., Eusterbrock T., Kim S. Intrauterine gastric perforation. Pediatr Surg Int. 2006. 22:829–31.
10). Shaker IJ., Schaefer JA., James AE Jr.., White JJ. Aerophagia, a mechanism for spontaneous rupture of the stomach in the newborn. Am Surg. 1973. 39:619–23.
11). Meyer JL 2nd. Congenital defect in the musculature of the stomach resulting in spontaneous gastric perforation in the neonatal period; a report of two cases. J Pediatr. 1957. 51:416–21.
12). Ohshiro K., Yamataka A., Kobayashi H., Hirai S., Miyahara K., Sueyoshi N, et al. Idiopathic gastric perforation in neonates and abnormal distribution of intestinal pacemaker cells. J Pediatr Surg. 2000. 35:673–6.
13). Yamataka A., Yamataka T., Kobayashi H., Sueyoshi N., Miyano T. Lack of C-KIT+ mast cells and the development of idiopathic gastric perforation in neonates. J Pediatr Surg. 1999. 34:34–7. discussion 7-8.
14). Touloukian RJ., Posch JN., Spencer R. The pathogenesis of ischemic gastroenterocolitis of the neonate: selective gut mucosal ischemia in asphyxiated neonatal piglets. J Pediatr Surg. 1972. 7:194–205.
15). Arnold GG. Perforation of the stomach in the neonatal period; report of a survival in a premature infant. J Pediatr. 1955. 46:276–9.
16). Houck WS Jr.., Griffin JA 3rd. Spontaneous linear tears of the stomach in the newborn infant. Ann Surg. 1981. 193:763–8.
17). Kiesewetter WB. Spontaneous rupture of the stomach in the newborn. AMA J Dis Child. 1956. 91:162–7.
18). Shaw A., Blanc WA., Santulli TV., Kaiser G. Spontance rupture of the stomach in the newborn: a clinical and experimental study. Surgery. 1965. 58:561–71.
19). Jawad AJ., Al-Rabie A., Hadi A., Al-Sowailem A., Al-Rawaf A., Abu-Touk B, et al. Spontaneous neonatal gastric perforation. Pediatr Surg Int. 2002. 18:396–9.
20). Inouye WY., Evans G. Neonatal gastric perforation. a report of six cases and a review of 143 cases. Arch Surg. 1964. 88:471–85.
21). Pasha Y., Chew NS. Massive pneumoperitoneum in an infant: the football sign. Br J Hosp Med (Lond). 2008. 69:714.
22). Aydin M., Zenciroğlu A., Hakan N., Erdoğan D., Okumus N., Ipek MS. Gastric perforation in an extremely low birth weight infant recovered with percutaneous peritoneal drainage. Turk J Pediatr. 2011. 53:467–70.
23). Glüer S., Schmidt AI., Jesch NK., Ure BM. Laparoscopic repair of neonatal gastric perforation. J Pediatr Surg. 2006. 41:e57–8.
24). Kang KJ., Song JH., Kim CS., Lee SL., Choi SO., Park WH. Comparison of clinical finding and mortality rate in neonatal gastrointestinal perforation due to necrotizing enterocolitis and other causes. Korean J Perinatol. 2011. 22:108–13.
Full Text Links
  • KJP
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr