Successful laparotomy in a 432 g extremely low-birth-weight infant with focal intestinal perforations

Area of Science:

• Neonatal surgery
• Pediatric surgery
• Gastrointestinal surgery

Background:

• Acute intra-abdominal conditions in extremely low-birth-weight (ELBW) infants present significant surgical challenges, often linked to increased morbidity and mortality.
• Focal intestinal perforations (FIP), distinct from necrotizing enterocolitis (NEC), are an emerging concern in ELBW neonates, necessitating prompt management.

Observation:

• A case report details an ELBW preterm male infant (24 weeks' gestation) weighing 432 g who underwent emergency laparotomy for FIP.
• The surgical procedure identified three isolated intestinal perforations unrelated to NEC.

Findings:

• The infant demonstrated a positive surgical outcome, achieving stability and significant weight gain (1142 g) by the 100th day post-operation.
• Initial assessment suggests that surgical intervention for FIP in ELBW infants does not exacerbate typical associated morbidities.

Implications:

• This case highlights the feasibility and potential benefits of surgical management for FIP in extremely low-birth-weight infants.
• Long-term developmental follow-up is crucial to fully ascertain the outcomes and optimize care for survivors of FIP requiring surgical intervention.