A STUDY OF PERITONITIS IN NEWBORNS AND INFANTS

Dr Jitendra Grover, Dr Qutubuddin Ali

Abstract


Background. To determine the characteristics of peritonitis in newborns and infants  in relation to the epidemiology, clinical picture and to study the clinical outcome  in newborns and infants admitted with peritonitis

Methods The patients included in the study were divided into 2 groups (Group A) newborns (< 30 day age), and (Group B) 1 month to 1 year age. Patients from both groups underwent thorough clinical evaluation ,lab. Tests  and outcome was seen and documented. In patients, undergoing surgery, operative findings and details of the operative procedure performed was recorded in detail. Regular postoperative assessment was performed and  any complications recorded in detail. The ultimate outcome was recorded.

Results Approximately half the NEC-PT and NEC-FT patients survived (45.46 % and 40%) while as many as 8/ 9 FIP patients, of whom 8 were FT, survived (88.9 %). Preterm babies with CP had the highest mortality (100 %).

Conclusion Though NEC was a major cause of intestinal perforation in neonatal age group but it was significantly higher in incidence in cases of perforation peritonitis in children up to the age of one year .Focal intestinal perforation was also a major cause of intestinal perforation but factors causing it were different from that of NEC.


Keywords


Necrotizing Enterocolitis,diarrhea, Neonate

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References


Chadha R. Peritonitis in children, in Gupta DK, Sharma S (Eds): Pediatric Surgery Diagnosis and Management, chapter 48. New Delhi, Jaypee Brothers Medical Publishers 2008: 544-563.

Wittman DH, Walker AP, Condon RE. Peritonitis and intraabdominal infection, in Schwartz S, Shires G, Spencer F (eds): Principles of Surgery (ed 6). New York, NY, Mc-Graw-Hill 1991: 1449-1483.

Boston VE. Necrotising enterocolitis and localized intestinal perforation: different diseases or ends of a spectrum of pathology. Pediatr Surg Int 2006; 22: 477-484.

St. Peter SD, Ostlie DJ. Necrotizing enterocolitis, in Hocomb III GW, Murphy JP (Eds): Ashcraft’s Pediatric Surgery (ed 5), Philadelphia, Saunders Elsevier chap 33. 2010: 461-476.

Grosfeld JL, Molinari F, Chaet M, Engum SA, West KW, Rescorla FJ, Tres Scherer III LR Gastrointestinal perforation and peritonitis in infants and children: Experience with 179 cases over 10 years. Surgery 1996; 120: 650-656.

Solomkin JS, Wittman DW, West MA, Barie PS. Intraabdominal Infections, in Schwartz SI, Tom Shires G, Spencer FC, Daly JM, Galloway AC (Eds): Principles of Surgery (ed 7), chap 32. New York, NY, Mc-Graw Hill 1999: 1515-1550.

Hwang H, Murphy JJ, Gow KW, Magee JF, Bekhit E, Jamieson D. Are localized intestinal perforations distinct from necrotizing enterocolitis ? J Pediatr Surg 2003; 38: 763-767.

Cass DL, Brandt ML, Patel DL, Nuchtern JG, Minifee PK, Wesson DE. Peritoneal drainage as definitive treatment for neonates with isolated intestinal perforation. J Pediatr Surg 2000; 35: 1531-1536.

Tam AL, Camberos A, Applebaum H. Surgical decision making in necrotizing enterocolitis and focal intestinal perforation: predictive value of radiologic findings. J Pediatr Surg 2002; 37: 1688-1691

Camberos A, Patel K, Applebaum H. Laparotomy in very small premature infants with necrotizing enterocolitis or focal intestinal perforation: postoperative outcome. J Pediatr Surg 2002; 37: 1692-1695.

Lessin MS, Schwartz DL, Wesselhoeft CW Jr. Multiple spontaneous small bowel anastomosis in premature infants with multisegmental necrotizing enterocolitis. J Pediatr Surg 2000; 35: 170-172

Patra S, Vij M, Chirla DK, Kumar N, Samal SC. Unsuspected invasive neonatal gastrointestinal mucormycosis: A clinicopathological study of six cases from a tertiary care hospital. Journal of the Indian Association of Pediatric Surgeons. 2012; 17: 153-156

Snyder CL, Gittes GK, Murphy JP, Sharp RJ, Ashcraft KW, Amoury RA. Survival after necrotizing enterocolitis in infants weighing less than 1,000 grams: 25 years experience at a single institution. J Pediatr Surg 1997; 32: 434-437

Ehlrich PF, Sato TT, Short BL, Hartman GE. Outcome of perforated necrotizing enterocolitis in the very low birth weight neonate may be independent of the type of surgical treatment. Am Surg 2001; 67: 752-756

Kumar V, Chattopadhyay A, Bhatt N, Rao PLNG. Spontaneous biliary perforation presenting as gastric outlet obstruction. Ind J Pediatr 2001; 68: 361-363


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