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Multicenter retrospective comparison of spontaneous intestinal perforation outcomes between primary peritoneal drain

Samantha Ahle1, Faidah Badru2, Rachelle Damle3

  • 1Section of Pediatric Surgery, Yale University School of Medicine/Yale-New haven Hospital, New Haven, CT.

Journal of Pediatric Surgery
|August 7, 2019
PubMed

Insights

Primary peritoneal drain is a successful treatment for spontaneous intestinal perforation (SIP) in infants, showing similar outcomes to laparotomy. While some cases require conversion to laparotomy, drain treatment offers comparable results for most infants with SIP.

Area of Science:

  • Neonatal surgery
  • Pediatric surgery
  • Gastrointestinal surgery

Background:

  • Spontaneous intestinal perforation (SIP) is a critical surgical emergency in neonates.
  • Treatment options for SIP include primary peritoneal drain and laparotomy.

Purpose of the Study:

  • To compare the clinical outcomes of infants with SIP treated with primary peritoneal drain versus primary laparotomy.

Main Methods:

  • Multi-institution retrospective review of 171 infants diagnosed with SIP between 2012 and 2016.
  • Comparison of clinical characteristics and outcomes between infants treated with primary peritoneal drain (n=110) and primary laparotomy (n=61).

Main Results:

  • No significant differences in complications, time to full feeds, length of stay, or mortality between the groups.
  • Patients treated with primary drain were more premature and had lower birth weights.
  • 29% of primary drain cases ultimately required laparotomy due to failure.

Conclusions:

  • Primary peritoneal drain is a successful initial treatment for the majority of infants with SIP.
  • Outcomes are comparable between primary drain and laparotomy, with drain treatment avoiding stoma formation in most cases.
Abstract

Keywords:
Necrotizing enterocolitisPeritoneal drainSpontaneous intestinal perforation

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