Management of Abdominal Compartment Syndrome in a Very Low Birth Weight Neonate Using Penrose Drains and Subsequent Management of Abdominal-Wall Defects

Abstract

Percutaneous drainage of the peritoneal cavity has been recently evaluated for the treatment of perforated viscous in the very low birth weight (VLBW) neonate and percutaneous decompression for abdominal compartment syndrome (ACS) has been studied in older patient populations. This is the first reported case of using this technique to treat ACS in a VLBW neonate.

Abdominal Decompression in Children

“…Needle decompression was reported in a child with ACS resulting from tension pneumoperitoneum [45]. The successful use of a Penrose drain has been reported in a very-low-birth-weight (VLBW) neonate weighing only 650 gm [75]. …”

“…Latenser et al's study reported peritoneal contamination that did not progress to peritonitis in one patient [14]. The VLBW neonate developed hernias at the catheter insertion sites upon removal of the Penrose drain, resulting in the need for reconstructive laparoscopic surgery [75]. Some patients have progressed to death in spite of decompression by catheter placement [49].…”

Bladder pressure and intra-abdominal hypertension in sick neonates

“…Known to lead to multi-organ dysfunction in adults and children [11][12][13], ACS is also associated with high pediatric mortality (40-60%) [8,13,14]. Although IAH and ACS are not frequently reported in the neonatal literature, there are case reports indicating that ACS can complicate neonatal extra corporeal membrane oxygenation [15], and that abdominal decompression to treat ACS might be managed percutaneously in the small premature infant [16]. Some authors suggest that IAH and ACS occur at lower IAP in children.…”