1. To drain or not to drain: a single institution experience with neonatal intestinal perforation.
- Author
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Bill Chiu, Srikumar B. Pillai, P. Stephen Almond, Mary Beth Madonna, Marleta Reynolds, Susan R. Luck, and Robert M. Arensman
- Subjects
LOW birth weight ,ARTIFICIAL pneumoperitoneum ,NEONATAL necrotizing enterocolitis ,PERITONEAL access ,ABDOMINAL surgery ,NEWBORN infants ,THERAPEUTICS - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2006
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