Tapping for pneumoperitoneum in neonates and infants

Ibrahim, Ibrahim A.; Ahmed, Ahmed E.

doi:10.1097/01.xps.0000426208.04511.b0

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…Fourth, it will prevent occurrence of abdominal compartment syndrome due to tension pneumoperitoneum. [ 17 ] Furthermore, abdominal drain placement is done in cases with marked abdominal distension causing respiratory embarrassment, which is not relieved by abdominocentesis. It also helps in continuous evaluation of the peritoneal contents.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous pneumoperitoneum in pediatric patients: Dilemmas in Management

Gupta

2018

J Indian Assoc Pediatr Surg

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Context:Pneumoperitoneum is typically a surgical emergency, particularly in neonates. However, pneumoperitoneum can rarely present without gastrointestinal perforation which is known as spontaneous pneumoperitoneum.Aims:This study aims to analyze the outcome of pediatric patients with spontaneous pneumoperitoneum and describe our experience.Settings and Design:A retrospective study performed from January 2014 to May 2017.Materials and Methods:The study included all pediatric patients admitted in a tertiary care institute.Results:There were 9 patients with 5 males and 4 females, out of which 7 were neonates. At presentation, respiratory distress was a common complaint (8/9). 5 out of all patients developed abdominal distension. Associated malformations were seen in 5 patients. Pneumoperitoneum was preceded by mechanical ventilation in 5 patients. Abdominal examination revealed soft distension with relaxed abdominal wall in 7, while marked distension was present in 2 cases. Features suggestive of peritonitis were absent in all the patients. Abdominal radiographs revealed free air in all, while, radiographic evidence of pneumothorax was seen in 2 patients. Conservative management without any operative intervention was performed in 3 patients with favorable outcome. Laparotomy was performed in 1 patient; negative for any perforation and outcome was unfavorable. In 5 patients, abdominocentesis was performed followed by abdominal drain placement. No patient had any evidence of leakage of intestinal contents from gastrointestinal tract after insertion of abdominal drain. Favorable outcome was present in 5 patients. Out of 4 cases with unfavorable outcome, 3 patients were having esophageal atresia.Conclusions:A high index of suspicion for spontaneous pneumoperitoneum must be present when dealing with pediatric patients, especially neonates with pneumoperitoneum and without clinical signs of peritonitis. A comprehensive clinical evaluation with sepsis screen must be carried out to supplement the diagnosis. Pneumoperitoneum in pediatric patients, especially neonates, is not always an absolute indication for surgery.

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Section: Discussionmentioning

confidence: 99%

Spontaneous pneumoperitoneum in pediatric patients: Dilemmas in Management

Gupta

2018

J Indian Assoc Pediatr Surg

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“…In neonates, about 10% of the pneumoperitoneum demonstrated radiologically occur without hollow viscus perforation [1]. Pneumoperitoneum is said to occur more in neonates than in infants and most cases are idiopathic [2]. However it may be caused by necrotizing enterocolitis (NEC), gastrointestinal tract perforation, iatrogenic causes such as mechanical ventilation and intrathoracic pathology (pneumothorax, pneumomediastinum) [3].…”

Section: Introductionmentioning

confidence: 99%

Severe pneumoperitoneum in a newborn without any established cause in a tertiary health institution in a low resource setting: A case report

Danfulani¹,

Ibrahim²,

Aliyu³

et al. 2020

World J. Adv. Res. Rev.

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Pneumoperitoneum is the presence of air within the peritoneal cavity. Pneumoperitoneum is said to occur more in neonates than in infants and most cases are idiopathic. However it may be caused by necrotizing enterocolitis (NEC), gastrointestinal tract perforation, iatrogenic causes such as mechanical ventilation and intrathoracic pathology (pneumothorax, pneumomediastinum). Plain abdominal radiograph has a good diagnostic value in evaluating patients with suspected pneumoperitoneum. Pneumoperitoneum can also be diagnosed using computed tomography (CT). A case of neonatal pneumoperitoneum without any established cause is reported due to its rarity. The approach to its management and radiological signs of pneumoperitoneum are also presented.

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