Management of neonatal spontaneous intestinal perforation by peritoneal needle aspiration

Abstract

Objective:

To describe conservative management of spontaneous intestinal perforation (SIP) in preterm infants using peritoneal needle aspiration (PNA).

Study design:

Monocentric retrospective review of SIP cases treated primarily by PNA between 1999 and 2015 (n=31).

Results:

Mean gestational age was 29.2±2.4 weeks and birthweight 1149±428 g. SIP occurred at 3.7±2.2 days of life. PNA achieved definitive treatment in 18 patients (60%) with a mean of 1.8 (±0.8) procedures. All patients requiring more than three PNAs had secondary laparotomy. Two patients died and five presented severe cerebral lesions. Full enteral feeding was achieved 42±18 days after SIP. Intestinal morbidity included cholestasis (n=6), intestinal stricture (n=1) and growth restriction (n=22). On follow-up (n=25, median=4 years), no severe impairment was noted. Seventeen children (68%) had a normal development.

Conclusion:

PNA as primary therapy for SIP is a viable option, resulting in definitive treatment in 60% of cases, with limited mortality and morbidity.

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Acknowledgements

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All authors contributed to: conception and design of the study, analysis and interpretation of the data, drafting and revision of the article. All of them approved the final manuscript as submitted.

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Correspondence to M Gébus.

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Gébus, M., Michel, J., Samperiz, S. et al. Management of neonatal spontaneous intestinal perforation by peritoneal needle aspiration. J Perinatol 38, 159–163 (2018). https://doi.org/10.1038/jp.2017.170

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