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Spontaneous intestinal perforation in neonates: is surgery always indicated?
Rizwan Ahmad Khan1, Jai Kumar Mahajan, Kataragadda Lakshmi Narasimha Rao
1Division of Paediatric Surgery, Department of Surgery, JNMCH, Aligarh, India. drrizwanahmadkhan@yahoo.co.in
Surgical intervention is standard for neonates with necrotizing enterocolitis (NEC) and pneumoperitoneum. However, conservative management is possible for select cases, offering a viable alternative.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
Background:
- Necrotizing enterocolitis (NEC) with pneumoperitoneum typically requires surgical treatment in neonates.
- Pneumoperitoneum without signs of peritonitis presents a unique clinical challenge for surgical management.
Observation:
- This study presents two cases of neonatal pneumoperitoneum.
- The cases highlight a rare phenomenon of pneumoperitoneum without associated peritonitis.
Findings:
- Conservative, non-surgical management was successfully implemented in both presented cases.
- Both neonates managed non-surgically demonstrated positive outcomes.
Implications:
- Non-surgical management is a feasible option for select neonates with pneumoperitoneum without peritonitis.
- This approach may reduce surgical morbidity in specific pediatric cases.
- Further research into criteria for conservative NEC management is warranted.
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