Clinical analysis of spontaneous gastric rupture in non-neonatal children

Background: Spontaneous gastric ruptures are rare in non-neonatal children, but once gastric rupture occurs, it results in rapid progression with high mortality. This study aimed to summarize the treatment experiences of 10 cases of spontaneous gastric rupture in non-neonatal children. We further investigated the etiology and treatment of spontaneous gastric rupture in non-neonatal children to reduce complications and improve efficacy. Methods A retrospective analysis was performed on 10 cases of spontaneous gastric rupture in children admitted to the Shanxi Children’s Hospital between January 2009 and December 2020. Abdominal radiography showed a large amount of free gas in the abdominal cavity, which confirmed gastric rupture. Therefore, surgical treatment was performed in all the patients. Results Of the 10 patients, 2 died postoperatively, 3 had anastomotic leakage after the second surgery following the primary operation, and 5 were treated by the primary operation. All living patients had no complications at the 1 year follow-up. Conclusions Acute gastric dilatation is the primary cause of gastric rupture. A large amount of free gas in the abdominal cavity on abdominal radiographs and extraction of gastric contents on abdominal puncture are valuable for diagnosing the disease. Preoperatively, fluid infusion is performed to correct shock as well as water, electrolyte, and acid-base imbalances. Gastric rupture should be treated surgically, and a simultaneous gastrostomy should be performed as it is key to ensure anastomotic healing.