Document Detail

Exploratory laparotomy or peritoneal drain? Management of bowel perforation in the neonatal intensive care unit.
MedLine Citation:
PMID:  17301667     Owner:  NLM     Status:  MEDLINE    
Premature infants in the neonatal intensive care unit are at risk for necrotizing enterocolitis (NEC) and bowel perforation. Unfortunately the mortality and morbidity for intestinal perforation in neonates, especially extremely low-birth-weight infants (VLBW), is high. The criterion standard traditional management for bowel perforation has been exploratory laparotomy (LAP). Another less invasive alternative treatment modality for selected intestinal perforation is primary peritoneal drainage (PPD). The role and efficacy of PPD as a definitive treatment instead of laparotomy remains to be determined. To better appreciate the emergence and evolving role of PPD in the management of intestinal perforation in NEC or isolated intestinal perforation, 8 selected research articles will be reviewed. Findings from these studies will be summarized to address the original purpose of PPD as a rescue and stabilizing measure for VLBW infants with complicated NEC, the expanded and superior role of PPD when it is used for VLBW infants with isolated ileal perforation, and PPD not as a sole surgical management but as an adjunct therapy to LAP in perforated NEC for the VLBW infants.
Helen Nguyen; Carolyn Houska Lund
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of perinatal & neonatal nursing     Volume:  21     ISSN:  0893-2190     ISO Abbreviation:  J Perinat Neonatal Nurs     Publication Date:    2007 Jan-Mar
Date Detail:
Created Date:  2007-02-15     Completed Date:  2007-05-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801387     Medline TA:  J Perinat Neonatal Nurs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  50-60; quiz 61-2     Citation Subset:  N    
Intensive Care Nursery, Children's Hospital & Research Center, Oakland, CA 94609, USA.
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MeSH Terms
Combined Modality Therapy
Drainage / methods*
Enterocolitis, Necrotizing / complications,  diagnosis,  therapy*
Ileostomy / methods
Infant, Newborn
Infant, Premature, Diseases / diagnosis,  therapy*
Infant, Very Low Birth Weight
Intensive Care, Neonatal / methods*
Intestinal Perforation / etiology,  radiography,  therapy*
Laparotomy / adverse effects,  methods
Neonatal Nursing / methods
Patient Selection
Resuscitation / methods
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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