Neonatal Gastrointestinal Perforations: a 7-year Single Center Experience at a Tertiary Neonatal Intensive Care Unit in Turkey

We aimed to present our experience on the gastrointestinal (GI) perforations and the factors affecting the outcome. A retrospective study carried out at a tertiary neonatal intensive care unit. A total of 38 neonates with GI perforation managed in our neonatal intensive care unit during 2005 to 2011 were included into the study. The patients were grouped as necrotizing enterocolitis (NEC) and non-NEC patients. Twenty four of 38 infants (63.2%) were premature. Non-NEC conditions were most common cause of the perforation (57.9%). Twelve cases were managed with peritoneal drainage alone. Surgical repair without conservative approach was performed in 19 patients, while seven of the patients underwent to surgical intervention after decompression by the percutaneous drainage. The overall mortality rate was 28.9%. It were 43.7% and 18.1% in NEC and non-NEC group, respectively (p>0.05). The mortality rate in small bowel perforation and colorectal perforation was 30.7% and 22.2%, respectively (p>0.05). All patients with gastric perforation survived. Non-NEC conditions were common cause of GI perforations. Although some patients could be managed with conservative approach, surgical exploration is still the main management model. The prognosis of the gastric perforation was good; however, the prognosis of small bowel and colorectal perforation was poor.