PERFORATION OF THE GASTROINTESTINAL-TRACT AND PERITONITIS IN THE NEONATE

  • 1 January 1985
    • journal article
    • research article
    • Vol. 160  (1) , 20-26
Abstract
A review of 60 neonates with perforation of the the gastrointestinal tract and peritonitis was undertaken to evaluate efficacy of current treatment. Perforation was most frequently associated with necrotizing enterocolitis, spontaneous gastric perforation, intestinal obstruction and feeding tube perforation of the duodenum. Primary closure of proximal gastrointestinal tract perforations and resections with diversion for distal perforations were the commonly used operative procedures. Mortality was 33%, with most deaths (80%) a result of sepsis or its complications. Increased risk of mortality was associated with lower birth weight lower weight for gestational age, males, initial serum pH < 7.30, delay in surgical treatment and feeding tube perforation. Peritoneal cultures were dominated by aerobic and facultative organisms with only 21% yielding mixed aerobic-anaerobic cultures. No anaerobes were retrieved from postoperative wound infections or abscesses, and only 1 of 22 postive blood cultures yielded an anaerobe. Antibiotic therapy included combinations of aminoglycoside beta-lactam antibiotics [ampicillin, gentamicin, kanamycin, and methicillin] and clindamycin. Improving survival in this population, particularly in infants less than 1 kg birth weight, was demonstrated.

This publication has 0 references indexed in Scilit: