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Intestinal perforation in the premature infant.

K Vongbhavit1,2, M A Underwood2

  • 1Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, Nakhon-Nayok, Thailand.

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|September 1, 2017
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Summary

Spontaneous ileal perforation (SIP) and surgical necrotizing enterocolitis (sNEC) are distinct conditions in premature infants. Caffeine, inhaled nitric oxide, and early transfusion may offer protective effects against these serious gastrointestinal issues.

Keywords:
Necrotizing enterocolitisfocal intestinal perforationpremature infantspontaneous intestinal perforation

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Area of Science:

  • Neonatalogy
  • Pediatric Surgery
  • Gastroenterology

Background:

  • Premature infants are at high risk for gastrointestinal complications.
  • Spontaneous ileal perforation (SIP) and surgical necrotizing enterocolitis (sNEC) are critical conditions requiring differentiation.
  • Understanding risk factors and potential protective measures is crucial for improving outcomes.

Purpose of the Study:

  • To compare demographic, clinical, and laboratory data between premature infants with SIP, sNEC, and controls.
  • To identify factors associated with SIP and sNEC.
  • To explore potential protective agents in premature infants.

Main Methods:

  • Retrospective case-control study.
  • Inclusion criteria: infants with birth weight < 2,000 grams and gestational age < 34 weeks.
  • Matched controls for infants with intestinal perforation.

Main Results:

  • 130 infants included: 30 SIP, 35 sNEC, 65 controls.
  • SIP onset was earlier (median 5 days) than sNEC (median 25 days).
  • Infants with perforation had higher mortality and morbidity; caffeine, inhaled nitric oxide, and early transfusion showed potential protective effects.

Conclusions:

  • Spontaneous ileal perforation and surgical necrotizing enterocolitis are distinct clinical entities.
  • Caffeine, inhaled nitric oxide, and early red cell transfusion warrant further investigation for protective roles.
  • Further research is needed to confirm these findings and guide clinical practice.