ArticleWorld journal of pediatrics : WJP2008
Is pneumoperitoneum an absolute indication for surgery in necrotizing enterocolitis?
Article in World journal of pediatrics : WJP, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 16 citations in OpenAlex.
- Portal venous gas value in predicting surgical necrotizing enterocolitis.Pediatric research · 2025Article
- A Nomogram for Predicting Surgical Timing in Neonates with Necrotizing Enterocolitis.Journal of clinical medicine · 2023Article
- Case report: Catastrophic event: neonatal gastric perforation and complication of capillary leak syndrome.Frontiers in pediatrics · 2023Article
- Conservative Management of Pneumoperitoneum in Necrotising Enterocolitis- Is it Possible?Journal of neonatal surgeryArticle
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Authors and funding
7 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundNecrotizing enterocolitis (NEC) is the most common gastrointestinal medical/surgical emergency in neonates. Non-operative support is needed in 70% of NEC cases, and surgical intervention in the rest 30%. Historically, pneumoperitoneum has been considered as an absolute indication for laparotomy. In the present study we emphasize that pneumoperitoneum is not an absolute indication for exploratory laparotomy in NEC cases.
methodsWe prospectively studied 58 patients with severe NEC having pneumoperitoneum on abdominal X-ray in the last 5 years. At the time of admission, the patients were given intravenous fluid, total parental nutrition, blood transfusion and broad spectrum antibiotics followed by abdominal tapping (paracentesis). All the patients with pneumoperitoneum were closely monitored for 48 hours if abdominal tapping was repeated. When the disease seemed to worsen clinically, radiologically and laboratorially, the patient was subjected to exploratory laparotomy.
resultsOf the 58 patients, 40 were treated conservatively whereas 18 underwent surgical intervention. The overall mortality in the present study was 12.1%, including 5% of the patients managed conservatively and 27% of the patients undergoing surgery.
conclusionsPneumoperitoneum is not an absolute indication for surgery in cases of neonatal NEC. Most of the patients can be treated conservatively.
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