Surgical Tactics in Perforations of Stomach and Small Intestine in Children (Literature Review)
- Authors: Gavrilyuk V.P.1, Severinov D.A.1, Ovcharenko A.M.1
-
Affiliations:
- Kursk State Medical University
- Issue: Vol 31, No 3 (2023)
- Pages: 489-500
- Section: Reviews
- URL: https://journals.rcsi.science/pavlovj/article/view/252564
- DOI: https://doi.org/10.17816/PAVLOVJ111829
- ID: 252564
Cite item
Abstract
INTRODUCTION: Currently, the number of pediatric patients urgently hospitalized with different variants of gastrointestinal perforations complicated with peritonitis, remains high. In the given work, the variants of the surgical treatment depending on the location of the perforation defect (stomach, duodenum, small intestine) are presented, and the most common causes of such conditions encountered in clinical practice, are described (perforation of Meckel’s diverticulum, spontaneous perforation of small intestine and stomach in children with extremely low body mass, patients with Ehlers–Danlos syndrome).
AIM: To determine the most relevant variants of surgical tactics in children with perforations of different parts of the gastrointestinal tract (in particular, stomach, small intestine) in conditions of peritonitis.
MATERIALS AND METHODS: In the process of studying the literature, 142 scientific publications were analyzed on Google Academy, PubMed, eLIBRARY information resources, published from 2002 to 2022. With this, works describing intestinal perforation with the underlying necrotic enterocolitis, were excluded from the study, since this category of patients requires a separate discussion and description of approaches to treatment.
CONCLUSION: According to the results of the analysis of scientific literature, variants of surgical tactics used in perforations of the gastric wall include (in the order from the most commonly used to the least common): laparotomy and suturing with excision of the edges of the defect; suturing in conditions of laparoscopy; atypical resection with the formation of a gastric ‘tube’ on the probe; resection of stomach. In duodenal perforations, the following methods are used: rhomboid duodeno-duodenoanastomosis according to Kimura, intracorporeal suture with endovideosurgical access; laparotomy and suturing of the defect in extensive necrosis. In spontaneous perforation in the small intestine, resection of the part of the intestine is advisable — anastomosis according to Santulli in combination with terminal ileostomy, simultaneous end-to-end anastomosis or application of intestinal stomas.
Keywords
Full Text
##article.viewOnOriginalSite##About the authors
Vasiliy P. Gavrilyuk
Kursk State Medical University
Email: wvas@mail.ru
ORCID iD: 0000-0003-4792-1862
SPIN-code: 2730-4515
MD, Dr. Sci. (Med.), Associate Professor
Russian Federation, KurskDmitriy A. Severinov
Kursk State Medical University
Author for correspondence.
Email: dmitriy.severinov.93@mail.ru
ORCID iD: 0000-0003-4460-1353
SPIN-code: 1966-0239
MD, Cand. Sci. (Med.)
Russian Federation, KurskAnatoliy M. Ovcharenko
Kursk State Medical University
Email: anatoly_franc98@vk.com
ORCID iD: 0000-0002-8301-6803
SPIN-code: 8624-8928
Russian Federation, Kursk
References
- Kucherov YI, Zhirkova YV, Shishkina TN, et al. Malformations of Intestine in Premature Infants under the Mask of Necrotizing Enterocolitis. Voprosy Sovremennoj Pediatrii. 2015;14(2):300–4. (In Russ). doi: 10.15690/vsp.v14i2.1303
- Adamou H, Habou O, Amadou–Magagi I, et al. Non-traumatic acute peritonitis in children: causes and prognosis in 226 patients at the National Hospital of Zinder, Niger. Med Sante Trop. 2017;27(3):264–9. doi: 10.1684/mst.2017.0692
- Vasuki R, Arun PS, Moothedath RM. A rare case of spontaneous gastric perforation in an adolescent. Int Surg J. 2018;5(9):3171–4. doi: 10.18203/2349-2902.isj20183743
- Kulkarni K, Tiwari Ch, Nagdeve N, et al. Spontaneous pre-pyloric perforation in children. Pediatr Oncall J. 2019;16(4):115–8. doi: 10.7199/ped.oncall.2019.35
- Goyal S, Garg A, Goyal S. Peptic perforation in children: a diagnostic dilemma. J Med Res. 2017;3(2):57–9. doi: 10.31254/jmr.2017.3206
- Khadjibaev AM, Pulatov DT, Tilemisov SO. «Furacilin test» in the diagnosis of covered perforated ulcers of the stomach and duodenum. The Bulletin of Emergency Medicine. 2018;11(2):5–8. (In Russ).
- Styazhkina SN, Pelina NA, Sitnikov VA, et al. Klinicheskiy sluchay. Variant taktiki pri travme dvenadtsatiperstnoy kishki. Dostizheniya Nauki i Obrazovaniya. 2018;(18):80–2. (In Russ).
- Zarate–Suarez LA, Urquiza–Suárez YL, García CF, et al. Acute abdomen and perforated duodenal ulcer in an adolescent: case report. Revista de la Facultad de Medicina. 2018;66(2):279–81. doi: 10.15446/revfacmed.v66n2.59798
- Yang T, Huang Y, Li J, et al. Neonatal gastric perforation: case series and literature review. World J Surg. 2018;42(8):2668–73. doi: 10.1007/s00268-018-4509-x
- Karavaeva SA, Podkamenev AV, Skopetc AA. Necrosis and perforation of the stomach in newborn babies and infants. Grekov's Bulletin of Surgery. 2020;179(5):36–40. (In Russ). doi: 10.24884/0042-4625-2020-179-5-36-40
- Bidaibayev AN, Yelubayev ZK, Akmoldayev YA, et al. Analysis of the problem of stomach perforations in newborns in the Karaganda region. Medicine and Ecology. 2020;(2):57–66. (In Russ).
- Skopetс AA, Karavaeva SA, Nemilova TK. Long-term results of treatment of newborns and infants with necrosis and perforation of the stomach and duo-denum. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(1):7–16. (In Russ). doi: 10.17816/psaic718
- Kozlov YuA, Rasputin AA, Baradieva PJ, et al. Surgical treatment of neonates with gastric perforation. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2019;9(1):47–56. (In Russ). doi: 10.30946/2219-4061-2019-9-1-47-56
- Akilov HA, Urmanov NT, Khodjayarov NR. Treatment of children with perforated ulcers of the stomach and duodenum in Tashkent. Russian Journal of Pediatric Surgery. 2020;24(1):53–6. (In Russ). doi: 10.18821/1560-9510-2020-24-1-53-56
- Zaporozhchenko AG, Gladky AP, Dovbysh OV, et al. Features of clinical course of perforated ulcers of stomach and duodenum in children. Zdorov’ye Rebenka. 2013;(8):121–4. (In Russ).
- Amanova MA, Smirnov AN, Kholostova VV, et al. Spontaneous perforation of the stomach and duodenum in children with Ehlers– Danlos syndrome. Experimental and Clinical Gastroenterology. 2021; 185(1):176–82. (In Russ). doi: 10.31146/1682-8658-ecg-185-1-176-182
- Gisak SN, Sklyarova EA, Vecherkin VA, et al. Modern causative pathogens of peritonitis in cases of the perforation of the stomach, small intestine or colon in children and optimization of the differentiated treatment of patients. Russian Journal of Pediatric Surgery. 2018;22(2):65–72. (In Russ). doi: 10.18821/1560-9510-2018-22-2-65-72
- Sokolov YuYu, Korovin SA, Tumanyan GT, et al. Surgical treatment of children with perforated gastric and duodenal ulcers. Russian Journal of Pediatric Surgery. 2017;21(1):10–4. (In Russ).
- Skopec AA. Duodenal perforation in newborns and young children. Russian Pediatric Journal. 2019;22(5):318. (In Russ).
- Pritulo LF, Peylivanov FP, Goncov SV, et al. Our experience in treating congenital malformations of duodenum in children. Tavricheskiy Mediko-Biologicheskiy Vestnik. 2018;21(1):124–30. (In Russ).
- Hattingh G, Salas–Parra RD, Nuzhad A, et al. Duodenal perforation in the pediatric population: two rare cases at a small community hospital. J Surg Case Rep. 2020;2020(11):rjaa455. doi: 10.1093/jscr/rjaa455
- Yan X, Kuang H, Zhu Z, et al. Gastroduodenal perforation in the pediatric population: a retrospective analysis of 20 cases. Pediatr Surg Int. 2019;35(4):473–7. doi: 10.1007/s00383-018-4420-4
- Shatrova KM, Gorbatyuk OM, Martinyuk TV. Pathogenesis, clinical and morphological features of gastro intestinal perforations in newborns. Perinatologiya i Pediatriya. 2013;(3):66–9. (In Russ).
- Belotserkovtseva LD, Kovalenko LV, Prisukha IN, et al. Optimization of surgical aid for bowel obstruction in premature infants with extremely low birth weight. Vestnik SurGU. Meditsina. 2017;(1):27–30. (In Russ).
- Gordon PV, Attridge JT. Understanding clinical literature relevant to spontaneous intestinal perforations. Am J Perinatol. 2009;26(4):309–16. doi: 10.1055/s-0028-1103514
- Rai BK, Alam MDS, Sah C, et al. Duodenal ulcer perforation in pediatric population: a rare entity. Medphoenix. 2020;5(1):79–81. doi: 10.3126/medphoenix.v5i1.31425
- Swanson JR, Hair A, Clark RH, et al. Spontaneous intestinal perforation (SIP) will soon become the most common form of surgical bowel disease in the extremely low birth weight (ELBW) infant. J Perinatol. 2022;42(4):423–9. doi: 10.1038/s41372-022-01347-z
- Ignatev EM, Efremenkov AM, Trunova RB, et al. Case of multiple acute small bowel perforations in a child aged 9 months old. Russian Journal of Pediatric Surgery. 2018;22(1):52–4. (In Russ). doi: 10.18821/1560-9510-2018-22-1-52-54
- Park KY, Gill KG, Kohler JE. Intestinal perforation in children as an important differential diagnosis of vascular Ehlers-Danlos syndrome. Am J Case Rep. 2019;20:1057–62. doi: 10.12659/ajcr.917245
- Gorbatyuk OM, Martynyuk TV, Shatrova KM. Clinical and morphological characteristics the gastrointestinal perforation in newborn. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2013;3(2): 31–6. (In Russ).
- Belotserkovtseva LD, Kovalenko LV, Prisukha IN. Results of premature infants treatment with spontaneous intestinal perforation and ileal dilatation, preceding abdominal catastrophe. Vestnik SurGU. Meditsina. 2018;(2):29–36. (In Russ).
- Gorbatyuk OM, Martynyuk TV, Shatrova KM. Differences in gastrointestinal perforations in newborn infants based on clinical and morphological data. Russian Journal of Pediatric Surgery. 2014;18(2):4–7. (In Russ).
- Ara C, Coban S, Kayaalp C, et al. Spontaneous intestinal perforation due to non-Hodgkin's lymphoma: evaluation of eight cases. Dig Dis Sci. 2007;52(8):1752–6. doi: 10.1007/s10620-006-9279-x
- Pumberger W, Mayr M, Kohlhauser C, et al. Spontaneous localized intestinal perforation in very-low-birth-weight infants: a distinct clinical entity different from necrotizing enterocolitis. J Am Coll Surg. 2002;195(6):796–803. doi: 10.1016/s1072-7515(02)01344-3
- Prisukha IN, Belotserkovtseva LD, Akselrov MA. Stratification of risk factors for intestinal perforation in premature infants and their influence on the choice of the moment of surgical intervention. Pediatrics. Journal named after G.N. Speransky. 2019;98(6):65–70. (In Russ).
- Zamir O, Goldberg M, Udassin R, et al. Idiopathic gastrointestinal perforation in the neonate. J Pediatr Surg. 1988;23(4):335–7. doi: 10.1016/s0022-3468(88)80201-x
- Hansen C–C, Søreide K. Systematic review of epidemiology, presentation, and management of Meckel's diverticulum in the 21st century. Medicine. 2018;97(35):e12154. doi: 10.1097/md.0000000000012154
- Shyla RS, Mahiliavets EV, Belyuk KS, et al. Complications of small intestine diverticula, cases from clinical practice. Journal of the Grodno State Medical University. 2019;17(2):219–23. (In Russ). doi: 10.25298/2221-8785-2019-17-2-219-223
- Kozlov YuA, Novozhilov VA, Timofeev AD. Spontaneous perforation of the intestine in prematurely born children. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(4):102–8. (In Russ).
- Kozlov YuA, Novozhilov VA, Koval'kov KA, et al. Results of the treatment of spontaneous intestinal perforation in preterm children. Russian Journal of Pediatric Surgery. 2017;21(6):284–9. (In Russ).
Supplementary files
