To drain or not to drain: a single institution experience with neonatal intestinal perforation
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Bill Chiu
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.
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©2006 by Walter de Gruyter Berlin New York
Articles in the same Issue
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- Hemorrhagic shock in obstetrics
- Altered protease expression by periarterial trophoblast cells in severe early-onset preeclampsia with IUGR
- Gestational diabetes mellitus in patients receiving long-term corticosteroid therapy during pregnancy
- Accuracy and influence of ascorbic acid on glucose-test with urine dip sticks in prenatal care
- Protein C, protein S, and thrombomodulin in amniotic fluid. A preliminary study
- Timing of cord clamping revisited
- Intrapartum cardiotocography – the dilemma of interpretational variation
- Maturation of the autonomic nervous system: differences in heart rate variability in premature vs. term infants
- Four chamber view plus three-vessel and trachea view for a complete evaluation of the fetal heart during the second trimester
- Pleural fluid/serum immunoglobulin ratio is a diagnostic marker for congenital chylothorax in utero
- Fetal brain sparing is strongly related to the degree of increased placental vascular impedance
- Outcome of fetuses in women with pregestational diabetes mellitus
- Outcome of fetuses in women with pregestational diabetes mellitus
- Inhaled nitric oxide therapy might reduce the need for hyperventilation therapy in infants with persistent pulmonary hypertension of the newborn
- To drain or not to drain: a single institution experience with neonatal intestinal perforation
- Infective puerperal endocarditis caused by Escherichia coli
- Correlation between plasma and urinary caffeine levels in preterm infants
- Fetal ascites secondary to urinary hydrocolpos
- Congress Calendar
- Suppression of IL-2 and IFN-γ production in women with spontaneous preterm labor
Articles in the same Issue
- Advances in Perinatal Medicine - 5th Annual meeting of the Italian Society of Perinatal Medicine held in Parma, Italy on June 15th – 17th 2006
- Hemorrhagic shock in obstetrics
- Altered protease expression by periarterial trophoblast cells in severe early-onset preeclampsia with IUGR
- Gestational diabetes mellitus in patients receiving long-term corticosteroid therapy during pregnancy
- Accuracy and influence of ascorbic acid on glucose-test with urine dip sticks in prenatal care
- Protein C, protein S, and thrombomodulin in amniotic fluid. A preliminary study
- Timing of cord clamping revisited
- Intrapartum cardiotocography – the dilemma of interpretational variation
- Maturation of the autonomic nervous system: differences in heart rate variability in premature vs. term infants
- Four chamber view plus three-vessel and trachea view for a complete evaluation of the fetal heart during the second trimester
- Pleural fluid/serum immunoglobulin ratio is a diagnostic marker for congenital chylothorax in utero
- Fetal brain sparing is strongly related to the degree of increased placental vascular impedance
- Outcome of fetuses in women with pregestational diabetes mellitus
- Outcome of fetuses in women with pregestational diabetes mellitus
- Inhaled nitric oxide therapy might reduce the need for hyperventilation therapy in infants with persistent pulmonary hypertension of the newborn
- To drain or not to drain: a single institution experience with neonatal intestinal perforation
- Infective puerperal endocarditis caused by Escherichia coli
- Correlation between plasma and urinary caffeine levels in preterm infants
- Fetal ascites secondary to urinary hydrocolpos
- Congress Calendar
- Suppression of IL-2 and IFN-γ production in women with spontaneous preterm labor
