Sezen ÖZKISACIK, Barlas ETENSEL, Mesut YAZICI, Münevver TÜRKMEN, Harun GÜRSOY

YENİDOĞANIN İATROJENİK MİDE PERFORASYONU: OLGU SUNUMU

ofagus, mide ve duodenum perforasyonları yenidoğanlarda ve çocuklarda nadirdir. Çeşitli etyolojik faktörlerbildirilmiş olmasına rağmen, nedeni tam olarak belli değildir.Solunum sıkıntısı nedeniyle gözlem altına alınan ve hikayesinde mideye orogastrik sonda takılarak yüksekbasınçlı aspiratör ile mide aspirasyonu yapıldığı öğrenilen hasta, hayatının 2. gününde karında distansiyongelişmesi nedeni ile çekilen direk karın grafisinde serbest hava tespit edilmesi üzerine yatırılıp acilen operasyonaalındı. Operasyonda midenin arka yüzünde kardianın 3 cm aşağı seviyesinde büyük kurvatura 1 cm mesafede,kenarlarında noktasal tarzda kanama odakları olan perforasyon alanı tespit edilip primer sütür ile onarıldı. Hastasorunsuz olarak taburcu edildi.Yenidoğan ve prematürelerde herhangi bir sorun nedeniyle oro/nazogastrik sonda takılacak ve/veya aspirasyonyapılacaksa yumuşak sonda seçimi ve düşük basınçla aspirasyon yapılması gerektiği inancındayız

Anahtar Kelimeler:

Yenidoğan, mide perforasyonu, iatrojenik, orogastrik sonda, mide aspirasyonu

Iatrogenic Neonatal Gastric Perforation: A Case Report

Perforations of the esophagus, stomach and duodenum are rarely encountered events in neonates and children. The etiology of gastric perforation in neonates is unclear at present, although various theories have been reported. Aneonate, admitted for respiratory distress to the neonatal intensive care unit was consulted by our Department of Pediatric Surgery for abdominal distention which developed in second day of his life. Postnatal history revealed utilization of high negative pressures during suctioning via administered orogastric tube. Due to free air determined at the abdominal x-ray, he was operated immediately. At the operation, a perforation area which had hemorrhagic spots at its borders at the posterior side of the stomach, three cm. below the cardia and at one cm. distance to the large curvature was seen and sutured primarily. Thereafter, the patient was discharged without any problems and with a complication-free followup. We believe that a soft catheter and low pressures should be used for neonates and premature newborns if orogastric catheter placement is necessary.

Keywords:

Neonatal, gastric perforation, orogastric tube, aspiration of stomach, iatrogenic,

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