Characteristic Radiological findings in Preterm Infants with Missed Intestinal Perforation

Authors

  • Sivasankar Jayakumar University Hospitals Leicester, Infirmary road, Leicester, LE15WW
  • Nitin Patwardhan University Hospitals Leicester, Infirmary road, Leicester, LE15WW

DOI:

https://doi.org/10.47338/jns.v3.91

Keywords:

Missed intestinal perforation, Pseudocyst, Necrotizing enterocolitis, Preterm, Neonate

Abstract

BACKGROUND: Pneumoperitoneum on radiological imaging is typical in intestinal perforation in necrotizing enterocolitis [NEC]. However, it is not seen in all cases and intestinal perforation is missed on occasions. We present a series of preterm infants with characteristic x-ray findings that on exploration revealed missed intestinal perforation.

METHODS: Retrospective review of neonates with intra-operative diagnosis of intestinal perforation which was missed on x-ray abdomen over a period of 6 months is being presented here.

RESULTS: Three neonates born at 24 (24-30) weeks of gestation were identified. PDA was noted in all 3 patients and they required ventilator and inotropic support. Feeds were commenced at 5 (2-7) days of life. All three patients were treated for NEC. Surgical opinion was sought in view of localized gas shadow in a fixed position seen on repeated x-rays in all three patients. All three patients had laparotomy and small bowel resection with ileostomy formation at a mean age of 26 (24-46) days. Intra-operatively, small bowel perforation and adjacent pseudocysts filled with air and intestinal contents were noted in all 3 patients. Post-operatively full feeds were established in all patients.

CONCLUSION: In premature infants with NEC, intestinal perforation can be missed on occasions. Our patients interestingly, developed characteristic abdominal x-ray findings that in our experience should prompt for surgical intervention.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Author Biographies

Sivasankar Jayakumar, University Hospitals Leicester, Infirmary road, Leicester, LE15WW

Department of Paediatric surgery

Nitin Patwardhan, University Hospitals Leicester, Infirmary road, Leicester, LE15WW

Department of Paediatric surgery

Downloads

Published

2014-06-29

How to Cite

1.
Jayakumar S, Patwardhan N. Characteristic Radiological findings in Preterm Infants with Missed Intestinal Perforation. J Neonatal Surg [Internet]. 2014Jun.29 [cited 2021Mar.3];3(3):J Neonat Surg. 2014; 3(3):27. Available from: https://jneonatalsurg.com/ojs/index.php/jns/article/view/91