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European Journal of Pediatrics

, Volume 177, Issue 6, pp 853–858 | Cite as

Peritoneal drainage in pneumoperitoneum in extremely low birth weight infants

  • Ilse Broekaert
  • Titus Keller
  • Daisy Schulten
  • Christoph Hünseler
  • Angela Kribs
  • Martin Dübbers
Original Article

Abstract

The aim was to determine if peritoneal drainage (PD) is a suitable treatment for pneumoperitoneum in extremely low birth weight (ELBW) infants. A retrospective chart review of 42 ELBW infants with pneumoperitoneum at the University Hospital of Cologne between November 2014 and April 2017 was performed. Forty-two infants with a median birth weight of 645 g (interquartile range (IQR) 550, 806) and a median gestational age of 24.3 weeks (IQR 23.2, 25.6) were treated for pneumoperitoneum. Twenty-six (62%) received PD, and in ten (38%), the drain could be removed without further intervention. Infants in the PD group were of significantly lower birth weight (622g vs. 750 g), age (4.5 vs. 10.0 days), and weight at diagnosis (538 vs. 778 g). The mortality in the PD group was 15% at 90 days of life, but no patient deceased in the primary laparotomy group.

Conclusion: We suggest PD with close evaluation of drainage and clinical course as an alternative treatment for pneumoperitoneum in ELBW infants allowing bridging the vulnerable first days of life until these infants are in a more stable condition. Despite not reaching statistical significance in our series, PD showed the trend towards higher mortality.

What is known:

Pneumoperitoneum is traditionally treated with laparotomy, but placement of peritoneal drainage (PD) is a valuable treatment option.

Previous randomized controlled trials have shown no significant differences in mortality for PD versus laparotomy.

What is new:

In our cohort, 38% of the infants with PD could be saved from secondary laparotomy, but in the PD group there was a trend towards higher mortality.

PD allows bridging the vulnerable first days of life until ELBW infants are in a more stable condition for possible laparotomy

Keywords

Preterm Laparotomy Peritoneal drainage Mortality Spontaneous intestinal perforation Necrotizing enterocolitis 

Abbreviations

ELBW

Extremely low birth weight

ICH

Intracranial hemorrhage

IQR

Interquartile range

NEC

Necrotizing enterocolitis

PD

Peritoneal drainage

PVL

Periventricular leukomalacia

SIP

Spontaneous intestinal perforation

Notes

Authors’ contributions

Ilse Broekaert: data acquisition, analysis and data interpretation, drafting of the manuscript

Titus Keller: analysis and data interpretation, drafting of the manuscript

Daisy Schulten: analysis and data interpretation, critical revision

Christoph Huenseler: data acquisition, analysis and data interpretation, critical revision

Angela Kribs: study conception and design, analysis and data interpretation, critical revision

Martin Duebbers: study conception and design, analysis and data interpretation, drafting of the manuscript

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Ilse Broekaert
    • 1
  • Titus Keller
    • 1
  • Daisy Schulten
    • 2
  • Christoph Hünseler
    • 1
  • Angela Kribs
    • 1
  • Martin Dübbers
    • 2
  1. 1.Department of PediatricsUniversity Children’s Hospital of CologneCologneGermany
  2. 2.Division of Pediatric SurgeryUniversity Hospital of CologneCologneGermany

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