[Is there justification for limited percutaneous surgical drainage in severe neonatal necrotizing enterocolitis in low birth weight premature infants?].
The usual treatment of complicated neonatal necrotizing enterocolitis (NEC) is resection of the necrotic bowel, lavage of the peritoneal cavity and diversion enterostomy. Low-birth-weight premature neonates with this condition are in special danger if general anesthesia and full exploratory surgery is contemplated. A relatively simple alternate procedure is percutaneous insertion under local anesthesia of a soft abdominal drain, most often in the right lower quadrant. The procedure is done in the neonatal intensive care unit without moving the whole set-up to the operating room. 4 such cases have been treated within the past year. 3 were discharged home as they did not require additional surgical treatment, not having developed intestinal stenosis or obstruction. 1 recovered from the acute episode, but succumbed to a severe intraventricular hemorrhage and respiratory failure 7 days after the procedure. Our limited but most gratifying experience, in addition to similar experience of others, encourages us to recommend this simple surgical approach in the very sick low-birth-weight premature with fulminant NEC.
Finaly
R
R
Dept. of Pediatric Surgery, Soroka Medical Center, Beer Sheba.
Cohen
Z
Z
Kapuller
V
V
Golan
A
A
Kurtzbart
E
E
Mares
A
A
D000005:Abdomen; D004322:Drainage / Q000379:methods*; D020345:Enterocolitis, Necrotizing / Q000601:surgery*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male