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Early post-operative fever after colorectal surgery in infants is common and rarely associated with infection

Jacky Z Kwong1, Eveline Lapidus-Krol2, Jacob C Langer2

  • 1Division of Pediatric Surgery, Department of Surgery, Rush University Medical Center, Chicago, IL, USA. jacky_z_kwong@rush.edu.

Pediatric Surgery International
|August 19, 2024
PubMed

Insights

Early post-operative fever in infants after colorectal surgery is common and rarely indicates infection. Further research is needed to identify infants requiring investigation versus observation.

Area of Science:

  • Pediatric Surgery
  • Infectious Disease
  • Neonatal Care

Background:

  • Early post-operative fever (within 48 hours) is frequent in pediatric patients but often not infection-related.
  • Established guidelines for adult post-operative fever evaluation are lacking for infants.
  • This study addresses the scarcity of data on pediatric post-operative fever investigation.

Purpose of the Study:

  • To determine which infants require investigation for fever after colorectal reconstructive surgery.
  • To identify factors associated with infection in infants with early post-operative fever.

Main Methods:

  • Retrospective chart review of infants (<1 year) undergoing elective anorectal malformations (ARM) or Hirschsprung Disease (HD) reconstruction.
  • Analysis of patient and perioperative characteristics to identify infection risk factors.
  • Inclusion of 68 infants (38 HD, 30 ARM) between June 2018 and April 2020.

Main Results:

  • 32.4% of infants experienced early post-operative fever.
  • Infection was confirmed in only two infants.
  • Pre-operative colostomy and longer operative times were linked to increased fever risk (p < 0.05).

Conclusions:

  • Early post-operative fever in infants undergoing colorectal surgery is common and seldom infectious.
  • Further research is essential to guide appropriate work-up and observation strategies for these infants.
Abstract

Keywords:
Anorectal malformationHirschsprung diseasePost-operative fever

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