Abstract
Gastric pneumatosis is extremely rare during infancy. It has been reported in association
with necrotizing enterocolitis or congenital abnormalities such as pyloric stenosis.
Here, we report a case of gastric pneumatosis in a premature neonate on synchronized
nasal intermittent positive pressure ventilation. No pneumatosis was noted in the
rest of the bowel or esophagus. There could have been mild damage in the gastric mucosa,
either related to the placement of the feeding tube or secondary to the use of indomethacin
or both. The condition was further aggravated by noninvasive ventilation. An increase
in intragastric pressure resulted in the submucosal dissection of air followed by
the development of gastric pneumatosis. Conservative management strategies, including
the use of a nasogastric tube for decompression and the withholding of feeding, successfully
managed the gastric pneumatosis in our patient. An uneventful recovery was made after
conservative management. Prompt recognition and evaluation of this condition were
essential for making the diagnosis.
Keywords
Gastric pneumatosis - preterm - neonate - synchronized nasal intermittent positive
pressure ventilation
