Korean J Pediatr.  2009 Nov;52(11):1216-1220. 10.3345/kjp.2009.52.11.1216.

Clinical experience of therapeutic effect of peritoneal drainage on intestinal perforation in preterm infants

• Lee JS
• Koo KY
• Lee SM
• Park MS
• Park KI
• Namgung R
• Lee C
• Choi SH

• KMID: 2281025
• DOI: http://doi.org/10.3345/kjp.2009.52.11.1216

Abstract

PURPOSE
To analyze and compare various cases in which peritoneal drainage was used as the primary treatment method in preterm infants with intestinal perforation. METHODS: Among the preterm infants of less than 28 weeks of gestation who were admitted to the neonatal intensive care unit (NICU) at the Gangnam Severance Hospital from April 2006 to April 2009, 7 who had developed intestinal perforation were studied retrospectively. We investigated the clinical characteristics, secondary operation performances, morbidities, complications, and mortalities. RESULTS: Among the 7 infants, 5 survived. Of the 5 cases, 3 received laparotomy, of which 2 were confirmed as having necrotizing enterocolitis. Of the 2 infants who died, 1 had received laparotomy before 48 h of peritoneal drainage, while the other had not received any subsequent treatment. Of the 7 children, 4 had patent ductus arteriosus (PDA), of which 3 had received indomethacin injection. Five infants had begun enteral feeding before they developed intestinal perforation. Of the 5 infants who survived, 4 were diagnosed with cholestasis. Of the 7 infants, 4 developed periventricular leukomalacia (PVL) and 3 developed rickets. CONCLUSION: Although the use of peritoneal drainage as the primary management of intestinal perforation in preterm infants is controversial, we suggest that it can be used for treating extreme premature neonates. Further randomized controlled study will be required to determine the feasibility of using this method.

Keyword

Peritoneal drainage; Intestinal perforation; Preterm infant

MeSH Terms

Child
Cholestasis
Drainage
Ductus Arteriosus, Patent
Enteral Nutrition
Enterocolitis, Necrotizing
Humans
Indomethacin
Infant
Infant, Newborn
Infant, Premature
Intensive Care, Neonatal
Intestinal Perforation
Laparotomy
Leukomalacia, Periventricular
Pregnancy
Retrospective Studies
Rickets
Indomethacin