To drain or not to drain: A single institution experience with neonatal intestinal perforation

Bill Chiu, Srikumar B. Pillai*, P. Stephen Almond, Mary Beth Madonna, Marleta Reynolds, Susan R. Luck, Robert M. Arensman

*Corresponding author for this work

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Aims: The optimal surgical treatment for extremely-low-birth-weight (ELBW) neonates with pneumoperitoneum is controversial. This study aimed to identify clinical factors associated with two known causes of pneumoperitoneum- necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP), and assesses the treatment outcome with primary peritoneal drainage (PPD) vs. laparotomy. Methods: We reviewed and analyzed clinical characteristics and outcome from records of neonates with pneumoperitoneum treated at our institution from January 1999 to January 2003. Results: Forty-six neonates (31 NEC, 15 SIP) were treated with either PPD (20 with NEC, 13 with SIP) or laparotomy (11 with NEC, 2 with SIP). In neonates who underwent PPD, those with NEC (vs. SIP) were less likely to have a patent ductus arteriosus, but were more likely to have been fed, have drains placed later in life, have a subsequent laparotomy, a longer total parental nutrition course, a higher 30-day mortality, and to take more days to begin enteral feeds. Conclusion: The etiology of pneumoperitoneum (NEC vs. SIP) in ELBW neonates can usually be determined preoperatively. Neonates with SIP should have a drain placed while those with NEC should undergo laparotomy.

Original languageEnglish (US)
Pages (from-to)338-341
Number of pages4
JournalJournal of Perinatal Medicine
Volume34
Issue number4
DOIs
StatePublished - Aug 1 2006

Keywords

  • Intestinal perforation
  • Necrotizing enterocolitis
  • Pneumatosis intestinalis

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

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