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Experience of management of pediatric upper gastrointestinal perforations: a series of 30 cases

BACKGROUND: This study aimed to explore the characteristics of pediatric upper gastrointestinal (UGI) perforations, focusing on their diagnosis and management. METHODS: Between January 2013 and December 2021, 30 children with confirmed UGI perforations were enrolled, and their clinical data were ana...

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Autores principales: Wang, Mengqi, Sun, Shuai, Niu, Qiong, Hu, Baoguang, Zhao, Haiyan, Geng, Lei, Fu, Tingliang, Qin, Hong, Zheng, Bufeng, Li, Hesheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10598647/
https://www.ncbi.nlm.nih.gov/pubmed/37886238
http://dx.doi.org/10.3389/fped.2023.1261336
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author Wang, Mengqi
Sun, Shuai
Niu, Qiong
Hu, Baoguang
Zhao, Haiyan
Geng, Lei
Fu, Tingliang
Qin, Hong
Zheng, Bufeng
Li, Hesheng
author_facet Wang, Mengqi
Sun, Shuai
Niu, Qiong
Hu, Baoguang
Zhao, Haiyan
Geng, Lei
Fu, Tingliang
Qin, Hong
Zheng, Bufeng
Li, Hesheng
author_sort Wang, Mengqi
collection PubMed
description BACKGROUND: This study aimed to explore the characteristics of pediatric upper gastrointestinal (UGI) perforations, focusing on their diagnosis and management. METHODS: Between January 2013 and December 2021, 30 children with confirmed UGI perforations were enrolled, and their clinical data were analyzed. Two groups were compared according to management options, including open surgical repair (OSR) and laparoscopic/gastroscopic repair (LR). RESULTS: A total of 30 patients with a median age of 36.0 months (1 day–17 years) were included in the study. There were 19 and 11 patients in the LR and OSR groups, respectively. In the LR group, two patients were treated via exploratory laparoscopy and OSR, and the other patients were managed via gastroscopic repair. Ten and three patients presented the duration from symptom onset to diagnosis within 24 h (p = 0.177) and the number of patients with hemodynamically unstable perforations was 4 and 3 in the LR and OSR groups, respectively. Simple suture or clip closure was performed in 27 patients, and laparoscopically pedicled omental patch repair was performed in two patients. There was no significant difference in operative time and length of hospital stay between the LR and OSR groups. Treatment failed in two patients because of severe sepsis and multiple organ dysfunction syndrome, including one with fungal peritonitis. CONCLUSION: Surgery for pediatric UGI perforations should be selected according to the general status of the patient, age of the patient, duration from symptom onset, inflammation, and perforation site and size. Antibiotic administration and surgical closure remain the main strategies for pediatric UGI perforations.
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spelling pubmed-105986472023-10-26 Experience of management of pediatric upper gastrointestinal perforations: a series of 30 cases Wang, Mengqi Sun, Shuai Niu, Qiong Hu, Baoguang Zhao, Haiyan Geng, Lei Fu, Tingliang Qin, Hong Zheng, Bufeng Li, Hesheng Front Pediatr Pediatrics BACKGROUND: This study aimed to explore the characteristics of pediatric upper gastrointestinal (UGI) perforations, focusing on their diagnosis and management. METHODS: Between January 2013 and December 2021, 30 children with confirmed UGI perforations were enrolled, and their clinical data were analyzed. Two groups were compared according to management options, including open surgical repair (OSR) and laparoscopic/gastroscopic repair (LR). RESULTS: A total of 30 patients with a median age of 36.0 months (1 day–17 years) were included in the study. There were 19 and 11 patients in the LR and OSR groups, respectively. In the LR group, two patients were treated via exploratory laparoscopy and OSR, and the other patients were managed via gastroscopic repair. Ten and three patients presented the duration from symptom onset to diagnosis within 24 h (p = 0.177) and the number of patients with hemodynamically unstable perforations was 4 and 3 in the LR and OSR groups, respectively. Simple suture or clip closure was performed in 27 patients, and laparoscopically pedicled omental patch repair was performed in two patients. There was no significant difference in operative time and length of hospital stay between the LR and OSR groups. Treatment failed in two patients because of severe sepsis and multiple organ dysfunction syndrome, including one with fungal peritonitis. CONCLUSION: Surgery for pediatric UGI perforations should be selected according to the general status of the patient, age of the patient, duration from symptom onset, inflammation, and perforation site and size. Antibiotic administration and surgical closure remain the main strategies for pediatric UGI perforations. Frontiers Media S.A. 2023-10-11 /pmc/articles/PMC10598647/ /pubmed/37886238 http://dx.doi.org/10.3389/fped.2023.1261336 Text en © 2023 Wang, Sun, Niu, Hu, Zhao, Geng, Fu, Qin, Zheng and Li. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Wang, Mengqi
Sun, Shuai
Niu, Qiong
Hu, Baoguang
Zhao, Haiyan
Geng, Lei
Fu, Tingliang
Qin, Hong
Zheng, Bufeng
Li, Hesheng
Experience of management of pediatric upper gastrointestinal perforations: a series of 30 cases
title Experience of management of pediatric upper gastrointestinal perforations: a series of 30 cases
title_full Experience of management of pediatric upper gastrointestinal perforations: a series of 30 cases
title_fullStr Experience of management of pediatric upper gastrointestinal perforations: a series of 30 cases
title_full_unstemmed Experience of management of pediatric upper gastrointestinal perforations: a series of 30 cases
title_short Experience of management of pediatric upper gastrointestinal perforations: a series of 30 cases
title_sort experience of management of pediatric upper gastrointestinal perforations: a series of 30 cases
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10598647/
https://www.ncbi.nlm.nih.gov/pubmed/37886238
http://dx.doi.org/10.3389/fped.2023.1261336
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