Korean Journal of Pediatrics 2009;52(11):1216-1220.
Published online November 15, 2009.
Clinical experience of therapeutic effect of peritoneal drainage on intestinal perforation in preterm infants
Jun Seok Lee3, Kyo Yeon Koo3, Soon Min Lee3, Min Soo Park1, Kook In Park3, Ran Namgung3, Chul Lee3, Seung Hoon Choi2
1Departments of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
2Departments of Surgery, Yonsei University College of Medicine, Seoul, Korea
3Departments of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
미숙아의 장천공에서 복막 배액술의 치료효과에 관한 임상적 경험
이준석3, 구교연3, 이순민3, 박민수1, 박국인3, 남궁란3, 이철3, 최승훈2
1연세대학교 의과대학 소아과학교실
2연세대학교 의과대학 외과학교실
3연세대학교 의과대학 소아과학교실
Correspondence: 
Min Soo Park, Email: minspark@yuhs.ac
Abstract
Purpose
: To analyze and compare various cases in which peritoneal drainage was used as the primary treatment method in preterm infants with intestinal perforation.
Methods
: Among the preterm infants of less than 28 weeks of gestation who were admitted to the neonatal intensive care unit (NICU) at the Gangnam Severance Hospital from April 2006 to April 2009, 7 who had developed intestinal perforation were studied retrospectively. We investigated the clinical characteristics, secondary operation performances, morbidities, complications, and mortalities.
Results
: Among the 7 infants, 5 survived. Of the 5 cases, 3 received laparotomy, of which 2 were confirmed as having necrotizing enterocolitis. Of the 2 infants who died, 1 had received laparotomy before 48 h of peritoneal drainage, while the other had not received any subsequent treatment. Of the 7 children, 4 had patent ductus arteriosus (PDA), of which 3 had received indomethacin injection. Five infants had begun enteral feeding before they developed intestinal perforation. Of the 5 infants who survived, 4 were diagnosed with cholestasis. Of the 7 infants, 4 developed periventricular leukomalacia (PVL) and 3 developed rickets.
Conclusion
: Although the use of peritoneal drainage as the primary management of intestinal perforation in preterm infants is controversial, we suggest that it can be used for treating extreme premature neonates. Further randomized controlled study will be required to determine the feasibility of using this method.
Key Words: Peritoneal drainage, Intestinal perforation, Preterm infant


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