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Archivos argentinos de pediatría

Print version ISSN 0325-0075


DONOSO FUENTES, Alejandro; ARRIAGADA SANTIS, Daniela; CRUCES ROMERO, Pablo  and  DIAZ RUBIO, Franco. Idiopathic gastric rupture in toddler: case report. Arch. argent. pediatr. [online]. 2012, vol.110, n.2, pp.e21-e24. ISSN 0325-0075.

Idiopathic gastric rupture is rare in children. Most of them occur in newborn. The authors report the case of a 2-year-old female toddler with no significant medical records. Clinical picture began 48 h before with abdominal pain, nausea and vomiting. She was admitted to the Emergency Room in poor general condition, with abdominal distension and rebound tenderness. Laparotomy was performed immediately show-ing multiple perforations in the posterior wall of the stomach. Partial gastrectomy was performed. Afterwards, she was admitted to ICU in shock. She received mechanical ventilation, intravenous fuid administration (260 ml/kg in 12 h), vasoactive support and antibacterial therapy (cefotaxime and metronidazole). Laboratory showed leukopenia and thrombocytopenia. Etiological study was entirely negative for toxic and drug consumption. Collagen disease was ruled out and serum level of gastrin was normal. Her post operative course was characterized by persistent fever caused by left subphrenic collection (positive culture for Candida galabrata). Peritoneal lavage via laparotomy and percutaneous drainage of the residual collections were performed. She completed 3 weeks of antibacterial and antifungal therapies with adequate outcome. Her follow-up in 12 months was uneventful.

Keywords : Gastric rupture; Toddler; Candida spp.

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