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http://dx.doi.org/10.3345/kjp.2009.52.11.1216

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

Lee, Jun Seok (Departments of Pediatrics, Yonsei University College of Medicine)
Koo, Kyo Yeon (Departments of Pediatrics, Yonsei University College of Medicine)
Lee, Soon Min (Departments of Pediatrics, Yonsei University College of Medicine)
Park, Min Soo (Departments of Pediatrics, Yonsei University College of Medicine)
Park, Kook In (Departments of Pediatrics, Yonsei University College of Medicine)
Namgung, Ran (Departments of Pediatrics, Yonsei University College of Medicine)
Lee, Chul (Departments of Pediatrics, Yonsei University College of Medicine)
Choi, Seung Hoon (Departments of Surgery, Yonsei University College of Medicine)
Publication Information
Clinical and Experimental Pediatrics / v.52, no.11, 2009 , pp. 1216-1220 More about this Journal
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.
Keywords
Peritoneal drainage; Intestinal perforation; Preterm infant;
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