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Spontaneous localized intestinal perforation and intestinal dilatation in very-low-birthweight infants

Tsugumichi Koshinaga1, Hiroshi Gotoh, Kiminobu Sugito

  • 1Division of Paediatric Surgery, Department of Surgery, Nihon University School of Medicine, Tokyo, Japan. tkoshina@med.nihon-u.ac.jp

Acta Paediatrica (Oslo, Norway : 1992)
|October 26, 2006
PubMed

Insights

Spontaneous localized intestinal perforation (SLIP) in very-low-birthweight infants is not significantly linked to intestinal dilatation. Perforation can occur anywhere in ischemic intestines, suggesting a common underlying cause for both conditions in these vulnerable infants.

Area of Science:

  • Neonatal surgery
  • Pediatric gastroenterology
  • Perinatal medicine

Background:

  • Spontaneous localized intestinal perforation (SLIP) is a serious condition in very-low-birthweight (VLBW) infants.
  • Intestinal dilatation is a frequently observed morphological feature in VLBW infants, raising questions about its association with SLIP.

Purpose of the Study:

  • To investigate the relationship between spontaneous localized intestinal perforation (SLIP) and intestinal dilatation in very-low-birthweight infants.
  • To analyze clinical and surgical findings in VLBW infants with presumed SLIP.

Main Methods:

  • Retrospective review of medical records for 13 VLBW infants (<1500 g) who underwent laparotomy for presumed SLIP between 1983 and 2003.
  • Analysis of maternal, prenatal, and perinatal factors, along with clinical and surgical findings at laparotomy.

Main Results:

  • Operative findings revealed localized ileal perforations in all cases.
  • Five patients exhibited intestinal dilatation, with perforations occurring either within or proximal to the dilated segments.
  • Absence of the muscularis propria was noted in the dilated intestine of four patients.

Conclusions:

  • No significant association was found between spontaneous localized intestinal perforation (SLIP) and intestinal dilatation in VLBW infants.
  • Perforation can occur in any ischemic intestinal segment during severe circulatory failure, not exclusively in dilated areas.
  • SLIP and intestinal dilatation may share a common pathophysiological basis in low-birthweight infants, though their specific disease processes might differ.
Abstract

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