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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
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Year : 2019  |  Volume : 24  |  Issue : 3  |  Page : 225
 

Idiopathic isolated gastric pneumatosis in a preterm neonate


Department of Neonatology, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India

Date of Web Publication6-Jun-2019

Correspondence Address:
Dr. Shilpa Kalane
3rd Floor, NICU, Superspecialty Building, Deenanath Mangeshkar Hospital, Pune - 411 004, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaps.JIAPS_175_18

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How to cite this article:
Kalane S, Patankar S. Idiopathic isolated gastric pneumatosis in a preterm neonate. J Indian Assoc Pediatr Surg 2019;24:225

How to cite this URL:
Kalane S, Patankar S. Idiopathic isolated gastric pneumatosis in a preterm neonate. J Indian Assoc Pediatr Surg [serial online] 2019 [cited 2019 Nov 19];24:225. Available from: http://www.jiaps.com/text.asp?2019/24/3/225/259754




A female baby, second of twin (dizygotic twins), born by emergency cesarean section at 31 + 2 weeks of gestation for premature prolonged rupture of membrane. There was no history of asphyxia or dysmorphism. Trophic feeds were initiated within 1 h of birth and were increased by 10 ml/kg/day. On day 6 of life, the baby had yellowish aspirates and was lethargic. The baby was kept nil per oral. Abdominal X-ray showed air in stomach wall [Figure 1] and [Figure 2], suggestive of gastric pneumatosis. The baby was managed conservatively as per standard unit protocol. The septic screen was positive (white blood cell 3190/Cmm, platelets 199,000/Cmm, C-reactive protein 40.4 mg/L, and blood culture was sterile). Antibiotics were started. Pneumatosis resolved within 24 h. Feeds were restarted 7 days after. Baby tolerated feeds well and was discharged.
Figure 1: X-ray abdomen anteroposterior view - linear gas in stomach wall suggestive of gastric pneumatosis

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Figure 2: X-ray abdomen lateral view - linear gas in stomach wall suggestive of gastric pneumatosis

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Pneumatosis, defined as gas within intestinal wall, can occur anywhere in the gastrointestinal tract.[1] Isolated gastric pneumatosis is rare and may be associated with fulminant necrotizing enterocolitis (NEC).[2] It is associated with NEC or proximal intestinal obstruction.[2] In the present case, associated clinical findings are suggestive of NEC. Prematurity seems to be the risk factor. The present case had nonobstructive isolated gastric pneumatosis which responded to conservative treatment. This case illustrates that isolated gastric pneumatosis can be the presenting feature of NEC and if diagnosed early and managed aggressively may have benign course.

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   References Top

1.
Travadi JN, Patole SK, Simmer K. Gastric pneumatosis in neonates: Revisited. J Paediatr Child Health 2003;39:560-2.  Back to cited text no. 1
    
2.
Chesley P, Stark R, McAdams R, Effmann E, Drugas G. Isolated gastric pneumatosis in a premature infant following steroid exposure. J Pediatr Surg Case Rep 2014;2:436-8.  Back to cited text no. 2
    


    Figures

  [Figure 1], [Figure 2]



 

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