PO-0336 Necrotizing Enterocolitis (nec) And Focal Intestinal Perforation (fip) Treatment In A Small Single-centre Neonatology

Octreotide, a somatostatin analogue, has been used for the management of patients with refractory chylothorax. Side effects related to the gastrointestinal system associated with octreotide are necrotizing enterocolitis (NEC) and focal intestinal perforation. NEC is the most common and dangerous gastrointestinal emergency in premature infants. We present the development of necrotizing enterocolitis after octreotide treatment in a preterm infant with idiopathic congenital chylothorax which settled after discontinuation of octreotide.

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Discriminating necrotising enterocolitis and focal intestinal perforation

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2020-321429 ◽

2021 ◽

pp. fetalneonatal-2020-321429

Author(s):

Janet Berrington ◽

Nicholas D Embleton

Keyword(s):

Clinical Trials ◽

Quality Improvement ◽

Preterm Infants ◽

Gestational Age ◽

Intestinal Perforation ◽

Necrotising Enterocolitis ◽

Single Centre ◽

Detailed Review ◽

Focal Intestinal Perforation ◽

Key Features

Discriminating necrotising enterocolitis (NEC) and focal intestinal perforation (FIP) is important for clinical trials, observational cohorts, quality improvement and aetiological understanding. Literature suggests that timing and key features diagnose and discriminate, and that NEC subclassifications exist. We used a detailed 10-year cohort of NEC and FIP cases in preterm infants born <32 weeks’ gestation from a single centre to explore antecedent factors, presentation and potential NEC subclassifications. 785 infants had 144 episodes of NEC and 38 of FIP. FIP presented earlier than NEC, but ranges overlapped, and 30% of NEC presented before day 14. Antecedent events (other than feed volumes) and outcomes did not differ between NEC and FIP. Currently used diagnostic/discriminatory features performed poorly, and subclassification identified few cases except transfusion-associated NEC. Contrary to existing literature, postnatal age at NEC presentation was not dependent on gestational age. Detailed review rather than simple definitions are required to separate NEC from FIP.

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Surgical decision making in necrotizing enterocolitis and focal intestinal perforation: Predictive value of radiologic findings

Journal of Pediatric Surgery ◽

10.1053/jpsu.2002.36696 ◽

2002 ◽

Vol 37 (12) ◽

pp. 1688-1691 ◽

Cited By ~ 70

Author(s):

Alda L. Tam ◽

Alfonso Camberos ◽

Harry Applebaum

Keyword(s):

Decision Making ◽

Necrotizing Enterocolitis ◽

Intestinal Perforation ◽

Predictive Value ◽

Surgical Decision ◽

Radiologic Findings ◽

Focal Intestinal Perforation ◽

Surgical Decision Making

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A Single-Center Experience with Very Low Birth Weight Infants and Focal Intestinal Perforation: Comparison of Primary Anastomosis versus Stoma Opening

European Journal of Pediatric Surgery ◽

10.1055/s-0037-1605348 ◽

2017 ◽

Vol 28 (05) ◽

pp. 426-432

Author(s):

Dario Consonni ◽

Francesco Macchini ◽

Giovanni Parente ◽

Andrea Zanini ◽

Stefania Franzini ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Intestinal Perforation ◽

Very Low Birth Weight ◽

Primary Anastomosis ◽

P Value ◽

Single Center ◽

Vlbw Infants ◽

Single Center Experience ◽

Focal Intestinal Perforation

Introduction We present a single-center experience with very low birth weight (VLBW) infants with focal intestinal perforation (FIP), comparing the results of primary anastomosis (PA) and stoma opening (SO). Materials and Methods Clinical records of VLBW infants with FIP who underwent surgery between 2006 and 2015 were reviewed. Patients were divided into two groups according to the procedure performed: limited bowel resection and PA or SO. Patients with gastric perforation or patients who underwent clip and drop were excluded. Information regarding birth weight (BW), gestational age (GA), weight at surgery (WS), number of abdominal reoperations, duration of parenteral nutrition (PN), and demise was recorded. Results In this study, 40 patients were included: 22 in PA group and 18 in SO group. BW was 865 g in PA and 778 in SO (p-value: 0.2). GA was 26.1 weeks in PA and 25.6 in SO (p-value: 0.3). WS was 1,014 g in PA and 842 in SO (p-value: 0.09). Duration of surgery was 115 minutes in PA and 122 in SO (p-value: 0.67). Five patients (23%) belonging to PA group developed complications and required SO. Five patients (23%) demised in PA group and six (33%) in SO (p-value: 0.2). Seventeen abdominal reoperations were performed in PA group and 22 in SO group (p-value: 0.08). Conclusion Both procedures appear to be safe. When possible, PA should be performed as it reduces the number of abdominal reinterventions.

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