Abstract
Extract: Our study presents an experimental model for studying gastric rupture in the newborn. We showed that gastric rupture could be produced in eight newborn rodents and in three puppies less than 10 days old after injection of 120 ml air at 100 mm Hg pressure in the rodents and 175 ml air at 240 mm Hg pressure in the puppies. Gastric rupture occurred with animals supine and with approximately 20 ml barium injected into the stomach. Positioning of the animal in the supine position permitted the barium to pool in the antralpyloric region of the stomach.
Speculation: We believe that spontaneous gastric rupture occurs as a result of a “fluid-air trap.” Pooling of liquid barium or food in the pylorus permits a physiologic outlet obstruction of the stomach. Our observations indicate that normal infants accumulate considerable amounts of air in the stomach while feeding. As the stomach distends reflux of air into the esophagus is impeded by an air-fluid trap at the esophageal-gastric junction. Thus, our study suggests that increased intraluminal pressure within the stomach is sufficient to cause gastric rupture in the newborn and that the fluid-air trap is an important mechaism in gastric rupture.
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James, A., Heller, R., White, J. et al. Spontaneous Rupture of the Stomach in the Newborn: Clinical and Experimental Evaluation. Pediatr Res 10, 79–82 (1976). https://doi.org/10.1203/00006450-197602000-00001
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DOI: https://doi.org/10.1203/00006450-197602000-00001
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