Idiopathic Spontaneous Intestinal Perforation in Neonates : Explorative Laparatomy or Primary Peritoneal Drainage ?

Abstract

Objective: To highlight our management of idiopathic spontaneous intestinal perforation (ISIP) in two medical teaching hospitals. Methods:Retrospective study was done between Sept. 2003-Sept 2011. Results:The total number of patients was 9. The gestational age ranged between 27-29 weeks. The age at presentation ranged between 8-21 days.All the patients were males. Clinically there was severe tympanic abdominal distention. Radiologically there was severe pneumoperitonium. Operatively there was single perforation with normal surrounding bowel. The treatment was primary explorative laparotomy in 4/9 patients and primary peritoneal (PPD) drainage in 5/9 patients. The total survival rate was 77.7%. The total morbidity rate was 25%. The morbidity and mortality rate after PPD were zero.Conclusions: ISIP is a serious condition associated with a high mortality rate if not promptly recognized and treated. To overcome the high mortality, PPD is a good option to rescue and stabilize the patient before the definitive treatment.