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Idiopathic intestinal perforations in the newborn: an increasingly common entity
G Weinberg1, S Kleinhaus, S J Boley
1Division of Pediatric Surgery, Montefiore Medical Center, New York, NY.
Journal of Pediatric Surgery
|October 1, 1989
Summary
Seven neonates with idiopathic intestinal perforations showed good outcomes. Pathologic examination did not reveal the cause, suggesting possible ischemic necrosis as the etiology for these infant intestinal perforations.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
- Surgical pathology
Background:
- Idiopathic intestinal perforations (IIP) in neonates are rare but serious conditions.
- Exclusion criteria were applied to rule out known causes of intestinal perforation in neonates, such as necrotizing enterocolitis or congenital anomalies.
- This study focuses on a specific cohort of neonates with IIP without identifiable causes.
Purpose of the Study:
- To report on a series of neonates treated for idiopathic intestinal perforations.
- To investigate the clinical characteristics and outcomes of these cases.
- To explore potential etiologies for IIP in the absence of common causes.
Main Methods:
- Retrospective case series of seven neonates treated for IIP between 1982 and 1987.
- Detailed exclusion criteria were used to define the study population.
- Clinical data, perforation sites, and pathological findings were reviewed.
Main Results:
- Seven neonates (24 hours to 1 week old) were treated for IIP; 4 were premature, 3 full-term.
- Perforations occurred in the jejunum, ileum, cecum, and transverse colon, predominantly on the antimesenteric border.
- All infants had favorable outcomes, with pathological examination failing to identify a definitive etiology.
Conclusions:
- Idiopathic intestinal perforations in neonates can have good outcomes even without a clear etiology.
- The study suggests a potential link to ischemic necrosis secondary to a localized vascular accident.
- Further research is needed to understand the underlying causes and the observed increase in cases.
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