Neonatal Gastric Perforation Temporally Associated with Nasogastric Tube Insertion: A Case Report.
Shukri Said Mohamed, Omar Adam Sheikh, Ahmet Sarac et al.
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Case in brief
A preterm male neonate, born at 34 weeks and weighing 1.5 kg, developed acute abdominal distension and respiratory distress 12 hours after nasogastric tube insertion for feeding. Abdominal radiography showed significant pneumoperitoneum, indicating gastric perforation. Emergency laparotomy revealed a 1-cm full-thickness perforation along the stomach's greater curvature, which was surgically repaired. The infant recovered with intensive postoperative care.
Diagnostic / clinical pearl
Clinicians should suspect gastric perforation in preterm or small-for-gestational-age neonates who exhibit rapid abdominal distension or signs of sepsis after nasogastric tube placement.
Why it matters
This case underscores the importance of distinguishing between mechanical and ischemic causes of gastric perforation, as timely intervention is critical for improving outcomes.