ArticleJournal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures)2026
Necrotizing enterocolitis with gastric perforation in a 24-day old preterm neonate.
Article in Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Neonatal gastric perforation (NGP) is a rare, life-threatening surgical emergency that predominantly affects premature and extremely low birth weight (ELBW) infants and remains associated with high mortality. Case presentation: A 600 g female infant born at 25/26 weeks of gestational age developed necrotizing enterocolitis (NEC) during the third postnatal week and deteriorated with abdominal distension and pneumoperitoneum. Emergency laparotomy on day 24 revealed a single posterior gastric wall perforation with circumferential necrotic margins; the nasogastric tube tip was located at the defect. After minimal debridement and primary two-layer closure, the infant survived a prolonged intensive care course complicated by recurrent sepsis, cholestasis, bronchopulmonary dysplasia, and later adhesive obstruction requiring adhesiolysis. Conclusions: Gastric perforation may represent an uncommon manifestation of severe NEC in ELBW infants. Delayed onset, necrotic margins, and systemic inflammatory deterioration may favor ischemic NEC-related injury over iatrogenic trauma. Early radiographic evaluation and prompt surgical exploration are crucial for survival.
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