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neonatal idiopathic digestive perforation
Monday 3 March 2008
Neonatal gastrointestinal perforation has been associated with high mortality rates (40% to 70%). It can occur in association with neonatal necrotizing enterocolitis (NNEC) (carrying a very high mortality rate) and meconium ileus.
Isolated intestinal perforation tends to occur in the smallest, most immature infants and has a better prognosis. It presents within the first two weeks of life, often before substantial feedings have been started. Many of the affected infants have been treated with inotropes, indomethacin and/or corticosteroids.
Infants with isolated intestinal perforation often present with a distended and discolored abdomen but have few signs of systemic compromise.
The presence or abscence of pneumatosis intestinalis can help to distinguish intestinal perforation secondary to NNEC from isolated idiopathic intestinal perforation.
Peritoneal drainage is the primary therapy for intestinal perforation and frequently the definitive therapy for isolated intestinal perforation.
Localization
neonatal idiopathic gastric perforation
neonatal idiopathic intestinal perforation
neonatal idiopathic colonic perforation
See also
neonatal digestive perforation
References
References
Cass DL, Brandt ML, Patel DL, Nuchtern JG, Minifee PK, Wesson DE. Peritoneal drainage as definitive treatment for neonates with isolated intestinal perforation. J Pediatr Surg 2000;35:1531-1536.
St-Vil D, LeBouthillier G, Lukas FI, Bensoussan AL, Blanchard H, Youssef S. Neonatal gastrointestinal perforations. J Pediatr Surg 1992;27:1340-1342.
Meyer CL, Payne NR, Roback SA. Spontaneous, isolated intestinal perforations in neoantes with birth weight less than 1000 g not associated with necrotizing enterocolitis. J Pediatr Surg 1991;26:714-718.
Aschner JL, Deluga KS, Metlay LA, Emmens RW, Hendricks-Munoz KD. Spontaneous focal gastrointestinal perforation in very low birth weight infants. J Pediatr. 1988 Aug;113(2):364-7. PMID: 3397802
Zamir O, Goldberg M, Udassin R, Peleg O, Nissan S, Eyal F. Idiopathic gastrointestinal perforation in the neonate. J Pediatr Surg. 1988 Apr;23(4):335-7. PMID: 3385586
