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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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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. |
format | Online Article Text |
id | pubmed-10598647 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
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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