Peritoneal drainage as definitive treatment for neonates with isolated intestinal perforation

Cass, Darrell L.; Brandt, Mary L.; Patel, Dinesh G.; Nuchtern, Jed G.; Minifee, Paul K.; Wesson, David E.

doi:10.1053/jpsu.2000.18299

Cited by 115 publications

(128 citation statements)

References 23 publications

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“…11 The surgical experience with these diseases suggest that SIP and NEC with perforation may not respond to peritoneal drainage in the same manner. [14][15][16][17][18][19][20] There is currently a multicenter randomized trial being planned to examine which surgical intervention to use with NEC and SIP respectively.…”

Section: Introductionmentioning

confidence: 99%

Discharge outcomes of extremely low birth weight infants with spontaneous intestinal perforations

et al. 2005

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Objective: To examine discharge outcomes of extremely low birth weight infants (ELBW) with spontaneous intestinal perforation (SIP).Study design: A single-center retrospective cohort study of all ELBW infants admitted to the University of Virginia neonatal intensive care unit between July 1996 and June 2004. Results:We found 35 patients with SIP (incidence 8.4%). The median gestational age was 25 weeks, median birth weight was 722 g, and 71% of the infants were male. Most infants (n ¼ 28) with SIP were diagnosed secondary to pneumoperitoneum; however, one-third (7) of infants <25 weeks had occult presentations without pneumoperitoneum. When controlled for gestational age, gender, multiple gestation, indomethacin, and glucocorticoid exposure, infants with SIP have a higher risk of PVL and death than infants without perforation.Summary: Periventricular leukomalacia and death are significantly associated with SIP in ELBW after adjusting for gestational age, multiple gestation, indomethacin, and glucocorticoid exposure.

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Section: Introductionmentioning

confidence: 99%

Discharge outcomes of extremely low birth weight infants with spontaneous intestinal perforations

et al. 2005

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“…PD provides definitive treatment for most premature infants with isolated intestinal perforation. Seventy-three percent of the neonates with perforation caused by NEC require subsequent laparotomy [46]. The results of this study are subjected to bias.…”

Section: Discussionmentioning

confidence: 89%

Low mortality in necrotizing enterocolitis associated with coagulase-negative Staphylococcus infection

et al. 2008

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The aim of this study was to correlate the clinical course of necrotizing enterocolitis (NEC) with infection by coagulase-negative Staphylococcus at the onset of the illness. Records of all newborn infants developing NEC between January 1998 and December 2001 were reviewed. NEC was classified according to the criteria of Bell et al. Numeric variables were described by standard statistical methods. Comparisons between subgroups were performed by parametric statistical tests. Forty-four patients developed NEC stage II (n = 25) or III (n = 19). The incidence was 0.024% of live births in the hospital, and the mortality rate was 9%. The main risk factor was prematurity (84%). Only one-fourth of the patients had gastric residuals. A platelet count of <100,000 cells/mm3 occurred only in grade III NEC. Blood cultures were positive in 34% of the patients. The predominant organism (73%) was coagulase-negative Staphylococcus (CoNS). Neither Clostridium nor Bacteroides species were isolated. Stage II patients were maintained nothing per os (NPO) for 9 +/- 3 days and received antibiotics for 10 +/- 3 days. All of the stage III patients required an operation. In one-third of them, primary peritoneal drainage was initially performed but all required further operative procedures. We report a low incidence and mortality rate of necrotizing enterocolitis. Thrombocytopenia is confirmed as a marker of severity. Positive blood cultures for CoNS may explain, at least in part, the low mortality reported.

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“…When it was initially created, the Fig. 2 Comparison between the ROC curves of SNAPPE-II and MDAS at the moment of the assessment by a surgeon natural history of NEC and intestinal perforation [29] were taken on account and Tepas established three different pathways which would lead to bowel perforation in very low birth weight neonates: sudden perforation with no previous metabolic derangement (which would correspond to neonatal intestinal perforation), bad response to medical treatment and metabolic derangement followed by signs of free intraperitoneal air, and bad response to medical treatment plus metabolic derangement without signs of free intraperitoneal air (the last two would correspond to NEC). The MDAS was presented as a good tool in the management of these patients, treating them with PD when there were not metabolic alterations, and with laparotomy when there were signs of metabolic impairment.…”

Section: Discussionmentioning

confidence: 99%

Could clinical scores guide the surgical treatment of necrotizing enterocolitis?

Pradas¹,

Couselo²,

Marijuán³

et al. 2011

Pediatr Surg Int

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Peritoneal drainage as definitive treatment for neonates with isolated intestinal perforation

Cited by 115 publications

References 23 publications

Discharge outcomes of extremely low birth weight infants with spontaneous intestinal perforations

Discharge outcomes of extremely low birth weight infants with spontaneous intestinal perforations

Low mortality in necrotizing enterocolitis associated with coagulase-negative Staphylococcus infection

Could clinical scores guide the surgical treatment of necrotizing enterocolitis?

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