Management of neonatal spontaneous intestinal perforation by peritoneal needle aspiration

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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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