Background: Necrotizing enterocolitis is a life-threatening inflammation of neonatal intestine of multifactorial etiology. In early stages, medical management is considered; while as a transmural disease with pneumatosis or perforation needs surgical attention. Primary peritoneal drainage has evolved as an alternative to classic exploratory laparotomy especially in sick preterm and very low birth weight infants.Methods: In our study, we tried to employ primary peritoneal drainage as an initial intervention in all surgical necrotizing enterocolitis patients and analyzed the results and final outcome in terms of total days in neonatal intensive care unit, total parenteral nutrition days, days to start oral feeds, need for laparotomy, mortality and other complications.Results: Around one-third patients were either very low or extremely low birth weight and 80% patients were preterm. Primary peritoneal drainage was successful without need for laparotomy in around 65% of patients. In the rest 34 patients, 24 were subjected to rescue laparotomy, while 10 could not be stabilized for major surgery. Overall mortality was 29.16%.Conclusions: Early bedside primary peritoneal drainage can be employed in all cases of NEC with perforation with rescue laparotomy to be determined by subsequent monitoring. This strategy seems to be safe and cost-effective in a resource challenged set up and lifesaving in sick and extremely low birth weight infants.
Background: Foreign body related extremity trauma is uncommon in children and mostly involves lower limb. Such cases are prone to get neglected or missed and present at a later date with complications. Careful management at the outset can avoid such complications. Clinical suspicion followed by diagnostic imaging and retrieval of foreign bodies in cases with delayed presentation is vital. Methods: A retrospective case series analysis of foreign body foot, diagnosed and managed over a period of 6 years, was carried out at our institute with the aim to highlight clinical presentation and management of cases with a neglected foreign body foot.Results: A total of 23 patients with diagnosis of foreign body foot were studied with 15 acute cases and 8 chronic neglected cases. The neglected cases ranged in age from 15 months to 96 months (Mean 58.87±28.32). Male to female ratio was 7:1. The history of trauma was concealed in 6 out of 8 cases. Three presented as abscess, 2 each as cellulitis and non-healing wound and one as a granuloma. Mean delay in foreign body removal was 57.12±67.94 days. Five patients had radiolucent while three had radiopaque foreign bodies.Conclusions: Clinical suspicion aided by radiography and/or ultrasonography is pivotal in diagnosis. Removal of foreign body can be done by wound exploration under local anaesthesia in most of the cases.
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