Document Detail


Postoperative pneumatosis intestinalis in infants does not automatically preclude enteral feeding.
MedLine Citation:
PMID:  11733914     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A degree of feed intolerance after neonatal abdominal surgery is common but in an otherwise well baby enteral feeding usually is continued at the highest tolerated level. However, the presence of rectal bleeding, pneumatosis intestinalis, or portal vein gas seen on plain abdominal x-rays suggest the possibility of postoperative necrotising enterocolitis. When this happens feedings usually are stopped for 7 to 10 days, and intravenous antibiotics and total parental nutrition are commenced. METHODS: The authors report 12 episodes of rectal bleeding and 11 episodes of pneumatosis intestinalis in 3 infants who previously had undergone neonatal abdominal surgery for intestinal malformations. In 7 of these episodes, feedings were neither stopped nor were antibiotics given. At the time of these 7 episodes, the infants were more than 3 kg in weight, had no significant cardiac or respiratory pathology, were all clinically stable, had no evidence of peritonitis, had no thrombocytopenia, and were greater than 37 weeks postconception. RESULTS: The 3 infants were monitored closely. There were no early or late problems observed attributable to this management. CONCLUSION: Carefully selected clinically stable patients that have postoperative pneumatosis intestinalis or exhibit rectal bleeding may be successfully managed by reduced enteral feedings with no antibiotics. J Pediatr Surg 36:1820-1823.
Authors:
A Abhyankar; J J Corkery; A D Lander
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  36     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2001-12-04     Completed Date:  2002-04-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1820-3     Citation Subset:  IM    
Copyright Information:
Copyright 2001 by W.B. Saunders Company.
Affiliation:
Institute of Child Health, University of Birmingham, Birmingham, England.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use
Comorbidity
Digestive System Surgical Procedures / adverse effects
Enteral Nutrition / methods*
Enterocolitis, Necrotizing / diagnosis,  epidemiology*
Gastrointestinal Hemorrhage / diagnosis,  epidemiology
Humans
Infant
Intestines / abnormalities*,  surgery*
Pneumatosis Cystoides Intestinalis / diagnosis*,  epidemiology,  radiography
Postoperative Complications / diagnosis*,  epidemiology,  radiography
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

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


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