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Surgery on Children Journal aims to publish issues related to Pediatric Surgery, Pediatric Neurosurgery, Pediatric Plastic Surgery, Pediatric Cardiovascular Surgery, Pediatric Orthopedic Surgery, Pediatric Vascular Surgery, Pediatric Gynecology and Obstetrics, Pediatric Ear Nose Throat, Ophthalmology, Pediatric Anesthesiology and Reanimation, Pediatric Urology, Pediatric Surgical Intensive Care Clinic, and other clinical surgery fields on children of the highest scientific and clinical value at an international level and accepts articles on these topics.

Index
Original Article
Role of percutane peritoneal drainage in management of neonatal pneumoperitoneum: is surgery always necessary?
Aims: The standard procedure in the management of neonatal pneumoperitoneum (NP) cases is laparotomy. However, in some of the cases in which surgery is not a viable option, percutaneous peritoneal drainage (PD) can be performed in order to stabilize the patient prior laparotomy. This study reviews the role of PD in NP patients using previous studies in the literature.
Methods: 26 neonates diagnosed with NP in Van Yüzüncü Yıl Faculty of Medicine, Van Training and Research Hospital neonatal ICU from April 2015 to January 2018 were retrospectively reviewed. In terms of surgical assessment, patients were divided into 2 groups according to their birth weight. Group A consisted of neonates with birth weight above 1000 grams whereas Group B consisted of neonates with birth weight above 1000 grams whereas Group B consisted of neonates with a birth weight of 1000 grams or below. Demographic values, diagnosis, and treatment methods were put on record in patient files.
Results: 10 cases (7 male – 3 female) in Group A had a mean body weight of 1850 (Range: 1070 – 3400 gr) grams. In this patient group, NP developed as a result of pneumothorax, necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP). 3 (30%) of the patients who were treated with classical approaches were lost during the treatment period. Group B consisted of 16 (9 male – 7 female) patients with a mean body weight of 780 (Range 470 – 950) grams. In this case group, NP developed as a result of NEC. PD was performed prior to conventional treatment procedures and 5 (31%) of the patients were lost during the treatment period.
Conclusion: Group B had similar mortality rates with Group A. result explains to us that PD is a viable option in stabilizing the patient prior to laparotomy as a starting procedure, especially in neonates below 1000 grams and deemed as surgically unstable.


1. He TZ, Xu C, Ji Y, Sun XY, Liu M. Idiopathic NeonatalPneumoperitoneum with favorable outcome: a case report and review.World J Gastroenterol. 2015; 21(20): 6417.
2. Khan RA, Mahajan JK, Rao KLN. Spontaneous intestinal perforationin neonates: is surgery always indicated ?. Afr J Paediatr Surg.2011; 8(2):249.
3. Williams NM, Watkin DF. Spontaneous pneumoperitoneum and othernonsurgical causes of intraperitoneal free gas. Postgrad Med J. 1997;73(863): 531-537.
4. Choo S, Papandria D, Zhang Y, et al. Outcomes analysis afterpercutaneous abdominal drainage and exploratory laparotomy fornecrotizing enterocolitis in 4,657 ınfants. Pediatr Surg Int. 2011; 27(7):747-753.
5. Broekaert I, Keller T, Schulten D, Hünseler C, Kribs A, Dübbers M.Peritoneal drainage in pneumoperitoneum in extremely low birthweight infants. Eur J Pediatr. 2018; 1-6.
6. Kubota A, Yamanaka H, Okuyama H, et al. Focal intestinal perforationin extremely-low-birth-weight neonates: etiological consideration fromhistological findings. Pediatr Surg Int. 2007; 23(10): 997-1000.
7. Mohammed, AA. Idiopathic spontaneous intestinal perforation inneonates: explorative laparatomy or primary peritoneal drainage?.Jordan Medical Journal.2015; 171(3191) :1-6.
8. Moore TC. Successful use of the “patch, drain, and wait” laparotomyapproach to perforated necrotizing enterocolitis: is hypoxia-triggered“good angiogenesis” involved ? Pediatr Surg Int. 2000; 16(5-6), 356-363.
9. Diesen DL, Skinner MA. Spontaneous sealing of a neonatal intestinalperforation by the omentum. Pediatr Surg Int. 2008; 43(12): 2308-2310.
10. Ein SH, Marshall DG, Girvan D. Peritoneal drainage under localanesthesia for perforations from necrotizing enterocolitis Pediatr SurgInt. 1977; 12(6): 963-967.
11. Goyal A, Manalang LR, Donnell SC, Lloyd DA. Primary peritonealdrainage in necrotising enterocolitis: an 18-year experience. PediatrSurg Int.2006; 22(5): 449-452.
12. Moss RL, Dimmitt RA, Henry MC, Geraghty N, Efron B. A meta-analysis of peritoneal drainage versus laparotomy for perforatednecrotizing enterocolitis. Pediatr Surg Int.2001; 36(8): 1210-1213.
13. Stokes SM, Iocono JA, Draus JM. Peritoneal drainage as the initialmanagement of intestinal perforation in premature infants. Am Surg.2014; 80(9): 851-854.
Volume 1, Issue 2, 2024
Page : 18-21
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