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

Idiopathic isolated gastric pneumatosis in a preterm neonate

Shilpa Kalane, Shreeprasad Patankar 
 Department of Neonatology, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India

Correspondence Address:
Dr. Shilpa Kalane
3rd Floor, NICU, Superspecialty Building, Deenanath Mangeshkar Hospital, Pune - 411 004, Maharashtra

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

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 2022 May 28 ];24:225-225
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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}{Figure 2}

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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2Chesley 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.