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Spontaneous intestinal perforation in neonates.

Charu Tiwari¹, Gursev Sandlas¹, Shalika Jayaswal¹

¹Department of Paediatric Surgery, TNMC and BYL Nair Hospital, Mumbai, Maharashtra, India.

Journal of Neonatal Surgery

|June 3, 2015

Summary

Spontaneous Intestinal Perforation (SIP) in newborns is a distinct condition. This study of four neonates shows SIP has a better outcome compared to perforations linked to Necrotizing Enterocolitis (NEC).

Keywords:

Hirschsprung’s disease NEC Neonatal Perforation Spontaneous

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Area of Science:

Neonatal surgery
Gastrointestinal disorders
Pediatric surgery

Background:

Spontaneous Intestinal Perforation (SIP) is defined as a newborn gastrointestinal tract perforation without a clear cause.
Differentiating SIP from other causes of neonatal bowel perforation is crucial for appropriate management.

Purpose of the Study:

To analyze the clinical presentation, management strategies, and outcomes of neonates diagnosed with Spontaneous Intestinal Perforation.
To establish SIP as a distinct clinical entity with a potentially better prognosis than other forms of neonatal intestinal perforation.

Main Methods:

Retrospective analysis of four neonates with spontaneous bowel perforation.
Evaluation of clinical data, including age at presentation, birth weight, gestational age, and diagnostic methods.
Review of surgical and non-surgical management approaches and patient outcomes.

Main Results:

The study included four neonates (3 male, 1 female) with a mean age of 11.4 days at presentation.
Management varied, including emergency laparotomy (2 neonates) and peritoneal drainage (2 neonates), with one improving without surgery.
Surgical interventions included ileostomy for ileal perforations (2 neonates) and primary repair for a transverse colon perforation (1 neonate); all neonates recovered well.

Conclusions:

Spontaneous Intestinal Perforation (SIP) represents a unique clinical condition in neonates.
Neonates with SIP demonstrate a more favorable outcome when compared to those with intestinal perforation secondary to Necrotizing Enterocolitis (NEC).