Gastrointestinal perforation in very low‐birthweight infants

Kawase, Yasuhiro; Ishii, Tetsuya; Arai, Hiroko; Uga, Naoki

doi:10.1111/j.1442-200x.2006.02282.x

Cited by 53 publications

(41 citation statements)

References 26 publications

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“…18,19 Although some investigators have raised concerns over the possibility of increased neonatal intestinal complications, 4,12 there are others who have not been able to support such claims. 3,20,21 The two cohort studies 22,23 that showed the largest positive association between prenatal indomethacin exposure and NEC were conducted retrospectively.…”

Section: Prenatal Indomethacin Exposurementioning

confidence: 99%

“…9,10 Before 1996, postnatal indomethacin administration at our center was used only to treat PDA, 7 but subsequently its use increased following reports that administration of indomethacin to very low birth weight infants within 6 to 12 h after birth was associated with a reduced rate of severe intraventricular hemorrhage. 9,10 With increased frequency and early use of indomethacin several reports linking indomethacin exposure to IIP 6,[11][12][13] and/or to NEC 6,14 emerged. Most of these retrospective studies did not carefully differentiate between IIP and NEC nor did they assess the relationship between prenatal indomethacin exposure and neonatal gut injury.…”

Section: Introductionmentioning

confidence: 99%

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Prenatal or postnatal indomethacin exposure and neonatal gut injury associated with isolated intestinal perforation and necrotizing enterocolitis

et al. 2010

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Objective: To examine the role of indomethacin in neonatal gut injury.Study Design: Infants born at gestational age X23 weeks and with birth weights 400-1200 g were included in this prospective prevalence study of neonatal gut injury. Infants with isolated intestinal perforation (IIP) confirmed at laparotomy or at autopsy or with necrotizing enterocolitis (NEC) were identified. Data were abstracted bi-weekly.Result: Among 992 study infants, 58 infants exposed solely to prenatal indomethacin did not show an increased rate of neonatal gut injury. Any postnatal indomethacin exposure (n ¼ 611) increased the odds of IIP (OR 4.17, CI, 1.24-14.08, P ¼ 0.02) but decreased the odds of NEC (OR 0.65, CI 0.43-0.97, P ¼ 0.04). There was a negative association between the timing of indomethacin-exposure and the odds of developing IIP (OR 0.30, CI 0.11-0.83, P ¼ 0.02). Compared with NEC, IIP occurred at an earlier age (P<0.05) and was more common (P<0.05) among infants who received early indomethacin (first dose at <12 h of age) to prevent intraventricular hemorrhage than among infants who were treated with late indomethacin for closure of a patent ductus arteriosus (PDA). Unlike the classic hemorrhagic ischemic lesions of NEC in which large areas of tissue were inflamed or necrotic, the IIP lesions were small and discrete.Conclusion: Early (<12 h) postnatal indomethacin exposure was associated with an increased odds of IIP in very low birth weight infants whereas its later use for closure of a PDA appeared to provide protection against NEC. The paradoxical effect of the timing of indomethacin on IIP versus on NEC may be related to the different pathogeneses of the two diseases. Our findings also suggest that PDA may contribute to NEC.

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Section: Prenatal Indomethacin Exposurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prenatal or postnatal indomethacin exposure and neonatal gut injury associated with isolated intestinal perforation and necrotizing enterocolitis

et al. 2010

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“…SIP happens especially in premature infants with very low birth weight (weight <1500 g), and extremely low birth weight (weight <1000 g). SIP is a different clinical entity from NEC, the most severe gastrointestinal complication in premature infants (1,6,7).…”

Section: Discussionmentioning

confidence: 99%

Oral Ibuprofen Induced Spontaneous Intestinal Perforation in a Preterm Infant

Hamilçıkan¹,

Büke²,

Bent³

et al. 2017

jpr

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“…1,5,6 Early diagnosis and treatment could be the most important factors to achieve a good outcome. Charac teristic clinical manifestations may include poor ac tivity, abdominal distension, respiratory distress, feeding intolerance, vomiting, and cyanosis.…”

mentioning

confidence: 99%

“…2 The major defects are proximal linear tears along the greater curvature that occur as a seromuscular lace ration, resulting in mucosal ballooning with a pinhole perforation on the top. 5,6 Primary surgical repair is the principal mode of treatment. The first successful surgical repair of gastric perforation was accomplished by Kellogg et al in 1951.…”

mentioning

confidence: 99%

Recurrent Gastric Perforation in a Neonate Recovered after Primary Surgical Repair and Percutaneous Peritoneal Drainage

et al. 2015

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Neonatal gastric perforation is a rare but fatal disease, occurred mainly in preterm infants. In general, primary surgical repair is the main treatment. To the best of our knowledge, there has been only one report of improvement of gastric perforation in neonates after percutaneous peritoneal drainage alone. We describe a case of gastric perforation in a premature extremely low-birth-weight infant girl of 25 +4 weeks gestational age.We present this case to emphasize that gastric perforation may improve with percutaneous peritoneal drainage.

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Gastrointestinal perforation in very low‐birthweight infants

Abstract: The authors experienced only one proven case of NEC (0.2%), 12 cases of SIP (2.2%) among 556 very low-birthweight infants admitted during 12 years. Antenatal NSAID were strongly associated with SIP.

Cited by 53 publications

References 26 publications

Prenatal or postnatal indomethacin exposure and neonatal gut injury associated with isolated intestinal perforation and necrotizing enterocolitis

Prenatal or postnatal indomethacin exposure and neonatal gut injury associated with isolated intestinal perforation and necrotizing enterocolitis

Oral Ibuprofen Induced Spontaneous Intestinal Perforation in a Preterm Infant

Recurrent Gastric Perforation in a Neonate Recovered after Primary Surgical Repair and Percutaneous Peritoneal Drainage

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