ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG THỦNG RUỘT Ở TRẺ SƠ SINH TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Objective: The aim of this study was to present the clinical and subclinical characteristics of neonatal intestinal perforation at the National Hospital of Pediatrics. Method: The study was conducted on 30 infants diagnosed with bowel perforation during surgery or on pathological results at the National Children's Hospital from May 2021 to March 2022. Data collected from patients included general characteristics and assessment of clinical and laboratory symptoms. Results: Intestinal perforation mainly occurs in the group of premature infants with and low birth weight of 70%, with a male: female ratio 2:1.The main clinical symptoms are abdominal distension, and dirty gastric juice (100%). Abdominal mass, scrotal swelling, and delayed passage of meconium were present in 25%, 5%, and 5%. 60% of children were identified as having pneumoperitoneum on X-ray radiographs. 56.7% of children with ultrasound showed turbid abdominal fluid. Research results show that the main cause of intestinal perforation in neonates is necrotizing enterocolitis 40%. The most common position of intestinal perforation occurred in the ileum (36.67%). Conclusion: The clinical manifestations of neonatal intestinal perforation are often nonspecific, mainly gastrointestinal symptoms including abdominal distension, and dirty gastric juice. Neonates with symptoms suggestive of intestinal perforation should be referred early for abdominal X-ray and ultrasonography. Pneumoperitoneum images on x-ray and ultrasound with free turbid peritoneal fluid are important laboratory symptoms in diagnosis, but the positive rate is still low. Early diagnosis and treatment minimize complications and mortality.