Role of the Penrose drain in the management of VLBW infants with perforated necrotising enterocolitis.
We studied the effectiveness of the Penrose drain in very low birth weight infants with BW < 1500g with perforated necrotizing Enterocolitis. We reviewed the infants with perforated NEC over the 9 years between 1995-2004. The inclusive criteria was free intraperitoneal air in VLBW infants < 1500g. A total 22 infants were studied. Gestational age ranged from 23 to 33 weeks. Perforated NEC was diagnosed on PFA. In all infants a Penrose drain was inserted in either the right or left lower abdominal quadrants. Most of the infants fell in the BW range 800g to 980g with median age of 16 days. The incidence of Perforated NEC was very high in females (81.8%) as compared to males (18.2%). A Penrose drain was inserted on the same day when the pneumoperitoneum was diagnosed. A total of 22 infants had a Penrose drain inserted. Two (9%) showed improvement, 20(91%) were taken to theatre for laparotomy. Thirteen (59%) had an ileostomy performed. Seven (31.8%) had extensive bowel necrosis and subsequently died. A total 15(68.2%) out of 22 survived with initial management of Penrose drain insertion and subsequent laparotomy. Penrose drain insertion is an effective first line treatment in the pre-term infant BW < 1500g, with perforated NEC.
Chauhan
K
K
Children's University Hospital, Temple Street, Dublin.
Kashif
S
S
Awadalla
S
S
D020345:Enterocolitis, Necrotizing / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007416:Intestinal Perforation / Q000601:surgery / Q000628:therapy*; D008297:Male; D016896:Treatment Outcome