The role of peritoneal drains in treatment of perforated necrotizing enterocolitis: recommendations from recent experience.
OBJECTIVE
Intraperitoneal drains have been used in the treatment of perforated necrotizing enterocolitis (NEC), especially in infants less than 1,000 g, yet their role is still debated. The authors wished to examine their more recent experience in the treatment of NEC to make recommendations for operative management.


METHODS
The authors reviewed the records of all infants seen between 1989 and 1995 who had clinical and radiological evidence of NEC at the Hospital for Sick Children, Toronto, Ontario. One hundred sixty-seven infants were treated for NEC and 73 (44%) infants required surgical intervention.


RESULTS
Forty-five patients had perforated NEC; 23 were treated initially by peritoneal drainage and 22 by primary laparotomy. The 23 newborns who had peritoneal drainage were of significantly lower birth weight, and 19 (83%) of these infants required subsequent laparotomy for worsening disease. The overall mortality rate for perforated NEC was 36%.


CONCLUSIONS
Insertion of a peritoneal drain is still useful in resuscitating small critically ill infants with NEC; however, the majority of these infants will also require laparotomy.
Ahmed
T
T
Division of Neonatology, Hospital for Sick Children, and Univesity of Toronto, Ontario, Canada.
Ein
S
S
Moore
A
A
D004322:Drainage; D020345:Enterocolitis, Necrotizing / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome