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[An infant with intestinal pneumatosis and pneumoperitoneum: the difficult decision not to intervene]

J Pisón-Chacón1, A Pérez-Martínez, N Lecumberri García

  • 1Complejo Hospitalario de Navarra. Cirugía Pediátrica. ja.pison@gmail.com.

Anales Del Sistema Sanitario De Navarra
|June 27, 2018
PubMed

Insights

Pneumoperitoneum in children, often caused by non-surgical issues like ventilation, doesn't always need surgery. A thorough patient assessment can prevent unnecessary operations and improve outcomes.

Area of Science:

  • Pediatric Surgery
  • Neonatology
  • Gastroenterology

Background:

  • Pneumoperitoneum in children can arise from non-surgical causes, including mechanical ventilation and severe respiratory conditions.
  • Aggressive surgical intervention for pneumoperitoneum without peritonitis may negatively impact patient prognosis.

Observation:

  • A case study of a male infant with a history of necrotizing enterocolitis and prior intestinal surgeries presented with abdominal distension, intestinal pneumatosis, and pneumoperitoneum.
  • The infant exhibited good general health, normal intestinal transit, and no signs of peritonitis despite radiographic findings.

Findings:

  • Conservative management, including fasting, intravenous antibiotics, nasogastric decompression, and parenteral nutrition, led to a favorable outcome.
  • Oral feeding was successfully reintroduced on the seventh day of admission, indicating resolution of the condition.

Implications:

  • This case highlights that pneumoperitoneum in pediatric patients does not invariably necessitate surgical intervention.
  • A comprehensive, interdisciplinary team approach to patient assessment is crucial for avoiding potentially harmful, aggressive treatments and optimizing care.

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